title: [Semicircular decompression for the treatment of old thoracolumbar fractures and intractable neuropathic pain].
abstract: OBJECTIVE
  To investigate the clinical outcomes of semicircular decompression in treating old thoracolumbar fractures and intractable neuropathic pain.
  
  
  METHODS
  From September 2009 to September 2013, 21 patients with old thoracolumbar fracture and intractable neuropathic pain were treated with semicircular decompression. Among initial surgery, posterior pedicle screw fixation was used in these patients, with or without laminectomy. All patients were male, range in age from 20 to 28 years old with an average of (25.00±2.38) years. Vertebral body residual bone block resulted in intra-spinal placeholder more than 50%. All patients were complete spinal cord injury (ASIA grade) or cauda equina injury. VAS scores was from 6 to 10 points with the mean of 7.14±0.91. In these patients, MRI, CT, X-rays were performed; denomination and dosage of analgesics were recorded; nerve function and pain status were respectively evaluated by ASIA grade and VAS score before and after operation.
  
  
  RESULTS
  All patients were followed up from 8 to 32 months with an average of (17.29±6.02) months. All bone fragments of spinal canal were removed and spinal cord decompressions were achieved. At final follow-up, VAS scores were from 0 to 8 points with an average of (2.43±2.46) points, and were obviously reduced than peroperative data (P<0.05). Eleven cases of them stopped analgesic intake and 7 cases reduced using. Three patients' symptoms and VAS scores were not improved.
  
  
  CONCLUSIONS
  Old thoracolumbar fractures and intractable neuropathic pain need receive imaging examination as soon as possible and consider semicircular decompression therapy if bone fragments were in vertebral canal and spinal canal stenosis existed. This therapy can effectively relieve pain and profit nerve functional recovery.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Jian-jun
authors.initials: JJ
authors.lastname: Li
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Liu
authors.forename: Tian-jian
authors.initials: TJ
authors.lastname: Zhou
authors.forename: Liang-jie
authors.initials: LJ
authors.lastname: Du
authors.forename: Yu-tong
authors.initials: YT
authors.lastname: Feng
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.forename: Ming-liang
authors.initials: ML
authors.lastname: Yang
authors.forename: De-gang
authors.initials: DG
authors.lastname: Yang
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D009437:Neuralgia / Q000209:etiology / Q000601:surgery*; D010148:Intractable Pain / Q000209:etiology / Q000601:surgery*; D016103:Spinal Fractures / Q000503:physiopathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D064232:Visual Analog Scale; D055815:Young Adult