Grade | Grading criterias | Surgical methods |
---|---|---|
Grade I (N = 86) | 1. Recalcitrant back pain, increased pain after activity 2. X-ray showed wedge-shaped changes in the vertebral body, and some patients could see the injured vertebral cavity; CT showed a wedge-shaped change with an internal cavity; MRI showed that the height of the injured vertebra was lost and the internal signal of the cavity was abnormal | Vertebral augmentation |
Grade II (N = 60) | 1. Recalcitrant back pain, increased pain after activity 2. X-ray showed wedge-shaped changes in the injured vertebra, while dynamical X-ray film showed obvious changes in the angle of upper and lower endplates and local instability; CT showed a wedge-shaped changes with an internal cavity; MRI showed that the height of the injured vertebra was lost and the internal signal of the cavity was abnormal | Posterior reduction fusion internal fixation or combined vertebral augmentation |
Grade III (N = 44) | 1. Recalcitrant back pain, increased pain after activity with radiating pain in the lower extremities or intermittent claudication 2. X-ray showed loss of height of injured vertebra; CT showed wedge-shaped lesions with internal cavities, lumbar spinal stenosis, and compression of the dural sac; MRI showed that the height of the injured vertebra was lost, the signal was abnormal, the dural sac was compressed, and the same level of spinal canal stenosis | Posterior decompression and reduction fusion and internal fixation |
Grade IV (N = 30) | 1. Recalcitrant back pain, increased pain after standing for a long time 2. X-ray showed a wedge-shaped change with severe height loss and kyphosis of the spine; CT showed wedge-shaped changes of injured vertebra, internal cavity and kyphosis deformity of spine; MRI showed loss of injured vertebral height, kyphosis of the spine, abnormal signals inside the injured vertebra | Posterior osteotomy with internal fixation and fusion |
Grade V (N = 18) | 1. Recalcitrant back pain, aggravated after activity; Or accompanied by radiating pain in lower limbs, intermittent claudication; 2. X-ray showed a wedge-shaped change and kyphosis of the spine; CT showed wedge-shaped change of injured vertebra, kyphosis deformity of spine, lumbar spinal canal stenosis and dural sac compression; MRI showed that the height of the injured vertebra was lost, the signal was abnormal, the dural sac was compressed, and the same level of spinal canal stenosis | Posterior osteotomy (decompression) with internal fixation and fusion |