Anterior approach for treatment of thoracolumbar burst fractures by decompression and bone graft / 中国矫形外科杂志

ABSTRACT

[Objective]To discuss the clinical effect of the anterior approach for the treatment of thoracolumbar burst fractures by decompression and bone graft.[Method]A total of 34 patients underwent anterior approach for the treatment of thoracolumbar burst fractures were retrospectively analyzed from September 2003 to September 2005.According to the Denis classification system,there were 6 type A,16 type B,6 type C,4 type D,and 2 type E.Preoperative and postoperative neurologic changes,spinal canal decompression,segmental angulation,and arthrodesis rate were evaluated.[Result]The average preoperative canal compressopm decreased from 66.5% to 2.0%.Mean preoperative segmental kyphosis improved from 22.10? to 2.30?.There was neurologic deterioration.Twenty-six(86.7%) of 30 patients with neurologic deficits had an improvement by at least one modified Frankel grade.All patients went on to apparently stable arthrodesis.[Conclusion]Types of anterior spinal instrumentation and reconstruction techniques allow direct anterior decompression of neural elements,improvement in segmental angulation,and acceptable rates of arthrodesis without the need for supplemental posterior instrumentation.