Posterior transpedicular decompression for thoracolumbar burst fractures

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Thoracolumbar burst fractures often cause spinal canal compromise and neurological deficits.
• Traditional anterior decompression may involve significant morbidity.
• Evaluating minimally invasive posterior approaches is crucial for patient outcomes.

Purpose of the Study:

• To assess the feasibility and efficacy of posterior transpedicular decompression for thoracolumbar burst fractures.
• To evaluate neurological recovery and safety of the posterior approach.

Main Methods:

• A consecutive series of 25 patients with thoracolumbar burst fractures and incomplete neurological deficits (ASIA B/C) underwent posterior transpedicular decompression and fusion.
• Canal compromise was measured preoperatively and postoperatively.

Main Results:

• Significant reduction in canal compromise from 51.7% to 15.3%.
• Neurological improvement observed in most patients (14 to ASIA D, 7 to ASIA C).
• Low complication rate, with two superficial and one deep infection.

Conclusions:

• Posterior transpedicular decompression is a feasible and effective alternative to anterior decompression for thoracolumbar burst fractures.
• This technique provides satisfactory canal decompression and promotes neurological recovery.
• The posterior approach offers a safe and viable surgical option for managing these complex spinal injuries.