Results of Combined 360-Degree Fusion versus Posterior Fixation Alone for Thoracolumbar Burst Fractures

Abstract

The optimal management of thoracolumbar fractures remains a matter of debates. A variety of treatment options is both available and effective, but none has been definitively proven superior. Especially in cases of anterior column involvement, the questions of how theses fractures should be approached and stabilized remains unanswered. Many authors have advocated conservative managements especially in stable fractures without neurological injury. But the risk of delayed neurological deterioration or the development of painful kyphosis are not well defined. Denis et al. reported 17% neurological complications and 17% severe kyphosis after nonoperative treatment. Decompression and stabilization surgeries can be performed anterolaterally or posteriorly. When the posterior route is used, access to the canal is gained by laminectomy or facetectomy. Posterior stabilization generally requires longer segment fixations which are placed more than two levels above and below the site of injury. The anterolateral retropritoneal approach allows the surgeons to perform corpectomy and fusion, reconstructing the anterior and middle column of the spine. And both the anterolateral and the posterior approaches have been associated with favorable result. Here we present result of two groups of patients in whom a staged posterior fusion following anterolateral fusion and posterior fixation only for unstable thoracolumbar burst fractures during follow up periods. Results of Combined 360-Degree Fusion versus Posterior Fixation Alone for Thoracolumbar Burst Fractures