ABSTRACT
Objective To discuss the operative efficacy of anterior- and postero-decompression plus pedicle screw instrumentation through posterior approach in the treatment of thoracolumbar burst fractures. MethodsFrom February 2006 to November 2009,28 patients with thoracolumbar burst fracture and spinal cord injury were treated with anterior-and postero-decompression plus pedicle screw instrumenattion through posterior approach.They were 19 men and 9 women,21 to 52 years of age (average,35.6 years).The fractures happened at T11 in 3 cases,at T12 in 11 cases,at L1 in 9 cases and at L2 in 5 cases.By AO classification,there were 16 cases of type A3,7 cases of type B and 5 cases of type C.By the ASIA(American Spinal Injury Association) system,6 cases were rated as grade A,12 cases as grade B and 10 cases as grade C. Bone grafting was performed according to different conditions of the patients.Results The patients were followed for 12 months to 24 months,with an average of 14 months.The X-ray examinations showed that the mean anterior border height of the injured vertebrae recovered from46.8％ ± 18.3％ of the normal height before operation to 90.3％ ± 14.2％ postoperatively; the mean posterior border height recovered from preoperative 80.4％ ± 12.4％ to postoperative 94.2％ ± 15.1％ ; and the mean cobb angle decreased from preoperative 20.1°± 11.5° to postoperative 2.7°± 2.4°. The differences between preoperation and postoperation were significant(P ＜ 0.05).According to the ASIA evaluation system,neurofunctional recovery was achieved in the cases of incomplete paralysis except in the 6 eases who had had complete spinal cord injury of Grade A. Conclusion Anterior- and posterro-decompression plus pediclescrew instrumentation through posterior approach is an effective method of treating thoracolumbar burst fractures.