Outcomes of Anterior Decompression and Anterior Instrumentation in Thoracolumbar Burst Fractures—A Prospective Observational Study With Mid-Term Follow-up

Abstract

Index, and Spinal Cord Independence Measure), neurological (ASIA Impairment Scale), and radiological (kyphosis, anterior vertebral height loss, canal encroachment %) parameters.Results: Patients were prospectively followed for a mean duration of 5.9 6 3.2 years (2.4-10 years). Statistically significant improvement was noted in functional outcomes from preop values (P-value , 0.001). 29 patients (80.5%) had improvement in neurology after surgery at the final follow-up with a positive correlation with % change in canal encroachment (r = 0.64, P 20.018). The mean preoperative kyphosis of 29.1 6 11.9 degrees got corrected to 9.4 6 3.8 degrees in immediate postop and 15.7 6 11.8 at the final followup(P , 0.001). Preoperative mean canal encroachment of 58.5 6 15.7% was reduced to 6.5 6 3.2% postoperatively (P , 0.001). Two patients developed neurological complications (subacute progressive ascending myelopathy), and 5 patients developed pulmonary com-plications. No pseudarthrosis, implant loosening, or cage migration was noted in any patient. Conclusion:Anterior surgery performed in 36 patients with thoracolumbar burst fractures in our study showed good outcomes. 80.5% of patients improved in neurology after surgery by at least one ASIA Impairment Scale grade. There was statistically significant improvement noted in radiological outcome (Kyphosis and Canal encroachment %) and functional outcome (Visual Analog Score, Oswestry Disability Index, and Spinal Cord Independence Measure score) after surgery in immediate postop and at the final follow-up. Only 13.8% of patients developed pulmonary complications that were managed successfully with chest drain.

The Comparison between Spinal Facet Joint Toothed Plate and Traditional Pedicle Screw‐rod on Reduction of Thoracolumbar Fracture

“…Pedicle screw fixation is a milestone in the development of spinal surgery 10,11 . In the past decades, both anterior and posterior surgical approaches have been used in the treatment of thoracolumbar fractures 12,13 . To date, the posterior approach for reduction and pedicle screw fixation has become the mainstream solution for thoracolumbar fractures in clinical practice.…”

“… 10 , 11 In the past decades, both anterior and posterior surgical approaches have been used in the treatment of thoracolumbar fractures. 12 , 13 To date, the posterior approach for reduction and pedicle screw fixation has become the mainstream solution for thoracolumbar fractures in clinical practice. For individual vertebral compression fractures, there has been an evolution from the past four‐screw fixation to the current six‐screw fixation.…”