Results of emergency operation for thoracolumbar vertebral column fixation by combined two incisions (front and behind) at Viet Duc Hospital from January 2005 to July 2006

ABSTRACT

Background: Vertebral column injuries are severe and common injuries in sugical emergencies. In vertebral column injuries, thoracolumbar location damages commonly because of its anatomic features. Objective: To describe clinical, subclinical features, and results of treatment in patients with vertebral column injuries who operated by combined two incisions; To discuss operative indications for thoracolumbar Burst fracture injuries. Subjects and method: The prospective study was performed in patients with thoracolumbar vertebral column injuries who operated at Viet Duc, from January to December 2005. All patients were evaluated about clinical, subclinical features, operative indications and techniques, and results. Results: The time from the accident to the operation was 24-72 hours (54.8%), over 6 days (25.8%), 3-6 days (12.9%), and 6-24 hours (6.5%). 13 of 31 cases damaged in L2, and 12 cases damaged in L1. The average time of operation was 5 hours 43 minutes (ranged 4 hours to 8 hours 30 minutes). The average transfused blood amount was one unit (ranged from 0 to 4 units). For complete paralysis, most patients recovered fully. For thoracolumbar Burst fracture injuries with incomplete paralysis, it should operate by front incision. In Burst fracture injuries with clear-off vertebra, no paralysis; it also should operate by front incision. Conclusions: The operation with combined two incisions (front and behind) was safe and effective technique for thoracolumbar vertebral column fixation.