Abstract
BackgroundAlthough anterolateral decompression and instrumentation has several advantages in treating thoracolumbar burst fractures, the risk factors for supplementary posterior instrumentation are still unclear.MethodsWe retrospectively reviewed 238 patients who underwent anterolateral decompression and instrumentation for single-level thoracolumbar burst fractures from January 2010 and March 2012. The influences of several potential risk factors that might affect supplementary posterior instrumentation were assessed using univariate and multivariate analyses.ResultsTwenty seven patients who developed worsening back pain without neurological deterioration after the anterolateral approach treatment need further posterior instrumentation fixation. The univariate analysis showed that age, disruption of the posterior longitudinal ligament complex (PLC), and fracture level were the risk factors for supplementary posterior instrumentation. However, age and integrity of the PLC were the independent risk factors for supplementary posterior instrumentation by multivariate analyses.ConclusionsSupplemental posterior instrumentation was necessary in 11.3% of cases following anterolateral decompression and instrumentation in the present study. Older age and disruption of the PLC were the independent risk factors in prediction of supplementary posterior instrumentation in treating thoracolumbar burst fractures.
Highlights
About 20% of thoracic and lumbar fractures belong to thoracolumbar burst fractures [1,2]
The vertebral column is reconstructed by inserting a prosthesis or graft, restoring height and correcting spinal angulation
The purpose of the present study is to identify risk factors that contribute to the need for posterior instrumentation after anterolateral decompression and stabilization for single-level thoracolumbar burst fractures using a multivariate statistical model
Summary
About 20% of thoracic and lumbar fractures belong to thoracolumbar burst fractures [1,2]. This kind of fracture is frequently associated with neurologic deficits because of encroachment on the neural elements and at times owing to the dynamic nature of the injury. The purpose of orthopedic surgery includes decompression of the neural elements, restoration of vertebral body height, correction of spinal deformity, The anterolateral retroperitoneal flank approach allows the surgeon to conduct corpectomy and decompression of the canal. The vertebral column is reconstructed by inserting a prosthesis or graft, restoring height and correcting spinal angulation. Anterolateral decompression and instrumentation has several advantages in treating thoracolumbar burst fractures, the risk factors for supplementary posterior instrumentation are still unclear
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