Authors
Abstract
Background: Most investigations agree that unstable thoracolumbar fractures require surgical treatment. There is, however, debate on the best approach-anterior, posterior or combined. We are reporting our short and mid-term results on a «posterior only» approach with ligamentotaxis-dependent canal decompression with a segmental instrumentation system.Methods: 37 consecutive patients with thoracic and lumbar vertebrae fractures over 4 year period, with a mean follow-up of 30 months, (12-46 months) were studied. The cases underwent subjective and objective evaluation, using the Denis back pain scale, functional independent measure, employment status, neurologic Frankel grading and radiographic indices of vertebral angles and height change.Results: Twenty patients were pain-free, 35 were functionally independent. Frankel neurological grading showed 1.6 points average recovery. The mean preoperative kyphoitc angle of 19.1º improved 1.1º post surgery and to 5.1º at final follow-up. There were 3 minor infections and one hardware failure.Conclusions: Posterior spinal decompression and instrumentation for unstable thoracic and lumbar fractures is safe, effective and is associated with effective, achievement of radiographic correction, and is easier than anterior approach.
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