KẾT QUẢ PHẪU THUẬT GÃY VỠ THÂN ĐỐT SỐNG NHIỀU MẢNH ĐOẠN BẢN LỀ NGỰC THẮT LƯNG TẠI BỆNH VIỆN VIỆT ĐỨC

Abstract

Objective: To evaluate the surgical outcomes of posterior transpedicular screw fixation for burst fractures of the thoracolumbar junction at Viet Duc Hospital. Methods: A retrospective descriptive study was conducted on 80 patients with burst fractures of the vertebral body (T11–L2) who underwent surgery at Viet Duc University Hospital between January 2024 and December 2024. Results: Among the patients, 68.75% were male and 31.25% female; the age group 40–59 years accounted for the highest proportion 61.25%. The leading cause was occupational injury 53.75%. Preoperatively, 44 patients 55% presented with sphincter dysfunction, which decreased to 30 patients immediately after surgery, 16 at one month, and only 9 patients 11.3% at six months. Postoperative correction demonstrated a reduction in mean kyphotic angle from 20.9° to 10.5°, with a slight increase to 12.2° at six months. Neurological recovery, assessed by the ASIA scale, showed that the proportion of patients with grade E increased from 38.75% preoperatively to 45% immediately after surgery, 57.5% at one month, and 78.75% at six months. Meanwhile, ASIA grade A cases decreased from 10% to 5%. Pain outcomes according to the Denis pain scale at six months were: Grade I in 52.5%, Grade II in 48.75%, and Grade III in 11.25%, with no cases in Grades IV or V. Short-term complications included one case of wound infection, 22 cases of urinary tract infection, and seven cases of pressure ulcers at one month. Long-term complications at six months included one case of screw breakage 1.25%, seven persistent pressure ulcers, and four urinary tract infections, with no mortality reported. Conclusions: Posterior transpedicular screw fixation for burst fractures of the thoracolumbar junction at Viet Duc Hospital yielded favorable outcomes: effective correction and maintenance of kyphotic angle stability, marked recovery of neurological and sphincter function, and significant pain reduction. The results highlight the importance of early surgical intervention, proactive complication prevention, and comprehensive postoperative rehabilitation. A continuous management program from the immediate postoperative phase to home-based care is necessary to improve patients’ quality of life and long-term prognosis