Modified Posterior Tubular Decompression for Thoracolumbar Burst Fractures with Neurological Deficits: A 2-Year...

To evaluate the effectiveness of a modified posterior tubular decompression approach for treating thoracolumbar burst fractures with neurological deficits.

We developed a modified posterior tubular decompression approach and applied it to the treatment of patients with thoracolumbar burst fractures and varying degrees of neurological injury. Data were collected from 29 patients treated at Beijing Tongren Hospital, Capital Medical University, between September 2021 and April 2022. Parameters include demographics, intraoperative details, preoperative and postoperative spinal canal area, American Spinal Injury Association grade, visual analog scale for back pain, and Oswestry Disability Index in a 2-year follow-up period.

Twenty-nine patients were enrolled (22 males and 7 females). Preoperative fracture classifications (Denis) included type IIA (n = 8, 27.6%), IIB (n = 6, 20.7%), IID (n = 4, 13.8%), IIIA (n = 6, 20.7%), and IIIB (n = 5, 17.2%). Mean intraoperative blood loss was 339.3 ± 175.7 ml (range 50-600 ml). The mean hospital stay was 12.0 ± 4.1 days (range 5-20 days). Preoperative mean spinal canal compromise was 41.38% ± 18.38%, significantly reduced postoperatively to 19.69% ± 10.10% (P < 0.05). The neurological recovery rate was 79.3% (23/29). At the 2-year follow-up, both visual analog scale and Oswestry Disability Index scores showed significant improvement at all time points compared to preoperative baselines (P < 0.05). No patient experienced postoperative neurological deterioration.

Modified posterior tubular decompression demonstrates an effective approach for treating thoracolumbar burst fractures with neurological deficits, yielding significant neurological improvement. It provides a viable alternative approach for guiding the treatment of this condition.