Case Control Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6001-6008
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6001
Effectiveness and postoperative rehabilitation of one-stage combined anterior-posterior surgery for severe thoracolumbar fractures with spinal cord injury
Bo Zhang, Jin-Chao Wang, Yu-Zhen Jiang, Qing-Peng Song, Yan An
Bo Zhang, Jin-Chao Wang, Yu-Zhen Jiang, Qing-Peng Song, Yan An, Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
Author contributions: Conceptualization: Zhang B contributed the conceptualization of the study; An Y, Wang JC, Song QP and Jiang YZ collected the data; An Y and Wang JC Formal analyzed the data; Wang JC, Song QP and Jiang YZ wrote the manuscript; Wang JC, Song QP and Zhang B reviewed and edited the manuscript.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Beijing Jishuitan Hospital (Approval No. 202110-05).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest concerning this article. No benefits in any form have been or will be received from any commercial party related directly or indirectly to the subject of this study.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement - checklist of items, and the manuscript was prepared and revised according to the STROBE Statement - checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Zhang, MD, Chief Doctor, Neurosurgeon, Professor, Surgeon, Department of Spine Surgery, Beijing Jishuitan Hospital, No. 31 East Street, Xinjiekou, Xicheng District, Beijing 100035, China. jishuitanjizhu@163.com
Received: December 27, 2021
Peer-review started: December 27, 2021
First decision: January 25, 2022
Revised: February 24, 2022
Accepted: April 25, 2022
Article in press: April 25, 2022
Published online: June 26, 2022
Processing time: 171 Days and 17.2 Hours
ARTICLE HIGHLIGHTS
Research background

Thoracolumbar fractures are usually accompanied by spinal cord injury, and anterior or combined anterior-posterior surgery is preferred for severe thoracolumbar fractures.

Research motivation

We have performed one-stage combined anterior-posterior surgery for severe thoracolumbar fractures with spinal cord injury at our center, and the outcomes are expected to be reported.

Research objectives

This study aimed to investigate the effectiveness and postoperative rehabilitation of one-stage combined anterior-posterior surgery for severe thoracolumbar fractures with spinal cord injury.

Research methods

One hundred and twenty patients with severe thoracolumbar fractures and spinal cord injury treated at our hospital from February 2020 to February 2021 were randomly enrolled, which were randomly divided into group 1 (one-stage combined anterior-posterior surgery) and group 2 (one-stage anterior-approach surgery). Blood loss, incision length, operation time, intraoperative X-rays, length of hospital stay, anterior vertebral height ratio, posterior vertebral height ratio, Cobb angle, canal-occupying ratio of the affected vertebra, and quality of life scores were compared between the two groups.

Research results

Blood loss was greater and the operation time was longer in group 1 than in group 2, with significant difference. Incision length, intraoperative X-rays, and length of hospital stay were not significantly different between the two groups. Preoperative function of the affected vertebrae was not significantly different between the two groups. In each group, the patients showed significant improvement after surgery. The anterior vertebral height ratio and the posterior vertebral height ratio in group 1 after surgery were significantly higher than those in group 2. The Cobb angle after surgery was significantly lower in group 1 than in group 2. The canal-occupying ratio of the affected vertebrae was not significantly different between the two groups. Before surgery, there was no significant difference in the quality of life scores between the two groups. The above indicators were significantly improved after surgery compared with before surgery in each group. In addition, these indicators were markedly better in group 1 than in group 2 after surgery.

Research conclusions

One-stage combined anterior-posterior surgery effectively improves the function of the affected vertebrae and the life quality of patients with severe thoracolumbar fractures and spinal cord injury.

Research perspectives

One-stage combined anterior-posterior surgery is worthy of popularization in clinical use.