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Decompression and circumferential stabilization of unstable spinal fractures
S D Gertzbein1, C M Court-Brown, R R Jacobs
1Acute Spinal Cord Injury Unit, Sunnybrook Medical Centre, Toronto, Ontario, Canada.
Spine
|August 1, 1988
Summary
This study presents a combined anterior-posterior surgical technique for unstable thoracolumbar fractures, showing significant neurological improvement and spinal alignment restoration in patients with severe spinal canal encroachment.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Spinal Trauma Management
Background:
- Unstable thoracolumbar fractures often involve significant spinal canal encroachment and kyphosis.
- Effective surgical management is crucial for neurological recovery and spinal stability.
Purpose of the Study:
- To evaluate the efficacy and safety of a combined anterior decompression with strut graft and posterior instrumentation technique.
- To assess neurological outcomes and spinal alignment in patients with unstable thoracolumbar fractures.
Main Methods:
- A cohort of 18 patients with unstable thoracolumbar fractures underwent anterior decompression, anterior strut grafting, and posterior instrumentation with local fusion.
- Preoperative and postoperative assessments included spinal canal encroachment and kyphotic angle measurements.
- Neurological status was evaluated using the Frankel grading system.
Main Results:
- 81% of patients with incomplete neurological deficits improved by at least one Frankel Grade.
- Mean spinal canal encroachment reduced from over 50% to 4.6%.
- Mean kyphotic angle improved from 21.8 degrees to 17.1 degrees, with low complication rates.
Conclusions:
- The described anterior-posterior surgical technique is effective and safe for treating unstable thoracolumbar injuries.
- This method offers significant neurological improvement and spinal stabilization.
- It is a recommended alternative when anterior instrumentation is unavailable.