Results of Staged 360-Degree Spinal Fusion for Unstable Thoracolumbar Burst Fracture

Abstract

Objective: The purpose of this study was to evaluate the results obtained in patients who underwent staged 360-degree fusion with posterior fusion following anterolateral fusion for unstable thoracolumbar burst fractures. Methods: The authors performed 360-degree fusion for thoracolumbar burst fractures in 21 patients between 2006 and 2010. We reviewed the medical records and follow-up data including preand postoperative neurological status, spinal canal compromise, segmental kyphotic angulations, complications, visual analogue scale (VAS) pain scores, and revision surgery rates. Results: The mean computed tomography-measured preoperative spinal canal compromise was 55.9±20.7%. The segmental kyphotic deformity measured 20.2±4.4° preoperatively and had been corrected to 4.5±2.8° postoperatively. The mean vertebral body height loss of 57.4±6.9% improved significantly to 1.2±0.7% at the final follow-up examination. The mean preoperative VAS pain score of 8.2±0.8 improved to 1.5±0.6 at discharge. There were no cases of vascular complication, neurological deterioration, or revision surgery. Conclusion: Unstable burst fracture of thoracolumbar spine managed by staged posterior fusion and anterolateral interbody fusionis effective for kyphosis correction, significant canal decompression, pain reduction, maintaining stabilization and neurological improvement.