Introduction to the treatment of thoracic vertebrae fractures

Thoracic fracture is a relatively rare type of fracture. The treatment of thoracic fracture should also be considered from many aspects. The most important thing is to consider the type of thoracic fracture, the degree of spinal cord injury, stability, etc. Different treatment methods should be adopted according to the different degrees of these.

1. Third degree thoracic vertebra fracture

Grade I is mechanical instability, such as involvement of the anterior and posterior columns or the middle and posterior columns, and gradual kyphosis.

Grade II is neurological instability. If the middle column is affected, the vertebral body may further collapse in the acute or late stage, angulate backwards, and cause spinal canal stenosis, resulting in neurological symptoms.

Grade III has both mechanical and neurological instability, involving three columns, such as fracture and dislocation.

2. Treatment Methods

1. Patients with simple sternal compression fractures without spinal cord injury do not need surgical treatment. Patients with spinal cord instability and spinal cord injury should undergo surgical decompression. The purpose is to decompress the spinal cord in time, restore and stabilize the spine, and maximize the recovery of residual spinal cord function and stabilize the spine.

2. For the treatment of unstable upper thoracic vertebrae fractures, most scholars currently believe that surgical treatment should be adopted, mostly through posterior incision and reduction, spinal cord decompression, internal fixation, and posterolateral bone grafting and fusion.

3. Anterior approach surgery for upper thoracic vertebra fractures requires splitting the sternum, which causes great interference to the septum, severe trauma, heavy bleeding, and is located deep and difficult to access. Especially since upper thoracic vertebra fractures are often caused by violence and have severe spinal cord damage, it is not suitable to perform a very traumatic open chest surgery.