Clinical Analysis of Anterolateral Approach with Instrumentation for the Thoracolumbar Lesions

ABSTRACT

Forty one patients with unstable thoracolumbar lesions were treated using anterior internal fixation device. There were 39 cases with unstable thoracolumbar fracture, 1 case with post-traumatic kyphosis, and 1 case with aspergillosis spondylitis. The procedures consisted of anterior decompression through vertebrectomy and discectomy, interbody fusion using autogenous iliac bone or rib, realignment and stabilization with Kaneda device(7 cases), or Z-plate ATL device(34 cases). Most patients with incomplete neurologic deficit were improved one or two grades according to Frankel's classification. No patient showed neurological deterioration after surgery. We concluded that the anteroloteral approach with instrumentation in various unstable thoracolumbar lesions would provide satisfactory neurologic improvement as well as immediate firm stability with early ambulation and high fusion rate involving only a minimum number of motion segments.