Transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury.

Ai-Min Wu,Yan Lin,Wen-Fei Ni,Fang-Min Mao,Yi-Jing Zheng,Yao-Sen Wu,Hua-Zi Xu,Xiang-Yang Wang,Paul Park

doi:10.1371/journal.pone.0105625

Ai-Min Wu, Yan Lin + Show 7 more

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https://doi.org/10.1371/journal.pone.0105625

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Journal: PloS one	Publication Date: Aug 22, 2014
Citations: 7	License type: CC BY 4.0

Affiliation: Wenzhou Medical University

Abstract

Study DesignA retrospective clinical study.ObjectiveTo evaluate the efficacy and safety of transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury.MethodsTwenty-six spinal cord injured patients with thoracolumbar fracture and dislocation were treated by transforaminal decompression and interbody fusion. The operation time, intraoperative blood loss, and complications were recorded; the Cobb angle and compressive rate (CR) of the anterior height of two adjacent vertebrae were measured; and the nerve injury was assessed according to sensory scores and motor scores of the American Spinal Injury Association (ASIA) standards for neurological classification of spinal cord injury.ResultsThe operative time was 250±57 min, and intraoperative blood loss was 440±168 ml. Cerebrospinal leakage was detected and repaired during the operation in two patients. A total of 24 of 26 patients were followed up for more than 2 years. ASIA sensory scores and motor scores were improved significantly at 3 months and 6 months after operation; the Cobb angle and CR of the anterior height of two adjacent vertebrae were corrected and showed a significant difference at post-operation; and the values were maintained at 3 months after operation and the last follow-up.ConclusionWe showed that transforaminal decompression together with interbody fusion is an alternative method to treat thoracolumbar fracture and dislocation.

Highlights

Thoracolumbar fractures and dislocations with spinal cord injury, especially those with spinal cord compression due to a damaged anterior intervertebral disc and bony fragments, lead to nerve injury
We showed that transforaminal decompression together with interbody fusion is an alternative method to treat thoracolumbar fracture and dislocation
Patient population From June 2007 to August 2011, a total of 26 consecutive patients with thoracolumbar fractures and dislocations treated by transforaminal decompression and interbody fusion in our department were enrolled in this study

Summary

Introduction

Thoracolumbar fractures and dislocations with spinal cord injury, especially those with spinal cord compression due to a damaged anterior intervertebral disc and bony fragments, lead to nerve injury. Anterior decompression or combined anterior and posterior decompression and fusion are recommended by surgeons [1,2,3]. The anterior approach can remove the damaged intervertebral disc and bony fragments directly, the complications and risks of anterior vascular and nerve injury are considerable [4,5]. The TLIF technique can remove the anterior compressed intervertebral disc and bony fragments, avoiding the decompression procedure of the anterior approach. We retrospectively reviewed 24/26 consecutive patients (two patients were lost) with thoracolumbar fractures and dislocations treated by transforaminal decompression and interbody fusion

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