Related Experiment Video
Updated: Oct 21, 2025
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Outcomes of Anterior Decompression and Anterior Instrumentation in Thoracolumbar Burst Fractures-A Prospective
Samarth Mittal1, Arvind Rana1, Kaustubh Ahuja1
1Department of Orthopaedics, AIIMS Rishikesh, Uttarakhand, India.
Objective:
To analyze the functional, neurological, and radiological outcomes after anterior surgery in thoracolumbar burst fractures.
Design:
Prospective observational study.
Setting:
Tertiary care hospital.
Patients:
Thirty-six patients with thoracolumbar burst fractures (T11-L2).
Intervention:
Anterior decompression, anterior column reconstruction with mesh cage, and instrumented stabilization.
Outcome:
Functional (Visual Analog Score, Oswestry Disability Index, and Spinal Cord Independence Measure), neurological (ASIA Impairment Scale), and radiological (kyphosis, anterior vertebral height loss, canal encroachment %) parameters.
Results:
Patients were prospectively followed for a mean duration of 5.9 ± 3.2 years (2.4-10 years). Statistically significant improvement was noted in functional outcomes from preop values (P-value < 0.001). 29 patients (80.5%) had improvement in neurology after surgery at the final follow-up with a positive correlation with % change in canal encroachment (r = 0.64, P -0.018). The mean preoperative kyphosis of 29.1 ± 11.9 degrees got corrected to 9.4 ± 3.8 degrees in immediate postop and 15.7 ± 11.8 at the final follow-up(P < 0.001). Preoperative mean canal encroachment of 58.5 ± 15.7% was reduced to 6.5 ± 3.2% postoperatively (P < 0.001). Two patients developed neurological complications (subacute progressive ascending myelopathy), and 5 patients developed pulmonary complications. No pseudarthrosis, implant loosening, or cage migration was noted in any patient.
Conclusion:
Anterior surgery performed in 36 patients with thoracolumbar burst fractures in our study showed good outcomes. 80.5% of patients improved in neurology after surgery by at least one ASIA Impairment Scale grade. There was statistically significant improvement noted in radiological outcome (Kyphosis and Canal encroachment %) and functional outcome (Visual Analog Score, Oswestry Disability Index, and Spinal Cord Independence Measure score) after surgery in immediate postop and at the final follow-up. Only 13.8% of patients developed pulmonary complications that were managed successfully with chest drain.
Level Of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
