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Abstract
Objectives
To identify the better option of treatment, we compared the surgical results and efficacy of combined anterior-posterior approach versus posterior fixation alone.
Methods
During a 10 years period from 2002 to 2011, 111 patients with thoracolumbar burst fracture was surgically managed at our institute. 25 patients were managed by a combined anterior-posterior surgery and 86 patients were managed by posterior fusion alone. Radiographs were repeated at 3, 6, 12 and 24 months after operation. Radiologic outcome was evaluated by measuring Kyphotic angulation and vertebral height and the clinical outcome was evaluated by visual analogue scale (VAS) score comparison.
Results
The average Cobb's angle difference between immediate post operative and last follow up was 15.0° in combined 360-degree fusion group and 7.5° in posterior surgery alone group. A corrections of vertebral body height between immediate post operative and last follow up was 2.27 mm in 360-degree fusion group while 0.59 mm in posterior fixation group. The VAS score decreased from 8.4 to 2.2 after post operation 24 months in 360-degree fusion group and the posterior surgery alone group decreased 9.3 to 6.2 after post operation 24 months.
References
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FIGURE 1.
A case of thoracolumbar vertebral fracture managed by 360-degree fusion. A: Axial computed tomography scan image of a fractured spine. Bilateral pedicles and facet joints were resected and a cage was inserted. B and C: Plain radiograph showing cage insertion and transpedicular screw fixation.
FIGURE 2.
Graph showing VAS score at admission, immediate post operation and 3, 6, 24 month after surgery. Group A was 360-degree fusion group and group B was posterior fixation group. VAS: visual analogue scale.
TABLE 1.
Characteristics of the patients in the 360-degree fusion groups and posterior fixation group
TABLE 2.
ThoracoLumbar Injury Classification and Severity (TLICS) Score∗
TABLE 3.
Summary of corrections for kyphotic angle and interbody height during follow up
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