Anterior surgical approaches for thoracolumbar burst fractures

ABSTRACT

The choice of optimal surgical procedure for thoracolumbar burst fractures remains controversial. To evaluate the results of anterior surgical approaches to thoracolumbar burst fractures as regard ease of the technique, safety and incidence of complications, postoperative stability and functional outcomes. A retrospective study of 18 patients with thoracolumbar burst fractures treated through an anterior surgical approach between March 2011 and 2012. We used both the Thoracolumbar Injury Classification and Severity [TLICS] score and the Load Sharing Classification score for selection of cases. Anterior corpectomy, grafting and Z-plate fixation were clone. Follow up of cases was documented as regard clinical and radiological results. There were 12 males and 6 females, with a mean age of 38.3 years. Falls were the most common cause. Tnmspleural thoracotomy approach done in 5 patients, thoraco abdominal approach in 9 patients and flank retroperitoneal approach in 4 patients. 2 patients died first day postoperatively due to DVT and pulmonary embolism. Satisfactory results occurred in 10 patients, 5 patients had no clinical improvement and Ipatient showed clinical deterioration. Anterior approach of the spine allows for one stage decompression, stabilization and deformity correction