title: Outcome of anterior decompression and stabilization for thoracolumbar unstable burst fractures in the absence of neurologic deficits.
abstract: METHODS
  This study investigated the outcome of anterior decompression and stabilization for "unstable" burst fractures without initial neurologic deficits in the thoracolumbar spine.
  
  
  OBJECTIVE
  To determine the pain and work status of the patients, who underwent the anterior decompression and stabilization, to evaluate the relationship between residual back pain and the degree of kyphosis, and to analyze the advantages and disadvantages of surgery for burst fractures without initial neurologic deficits in the thoracolumbar spine.
  
  
  BACKGROUND
  A retrospective review was conducted on 45 patients with unstable burst fractures in the thoracolumbar spine treated by anterior decompression and stabilization in our institutions from 1982 to 1993. Nineteen patients were available for this study. Ten patients were men and 9 were women. Their age at surgery ranged from 15 to 76 years (average, 46 years). The duration of follow-up ranged from 24 to 84 months (average follow-up, 54 months).
  
  
  METHODS
  All clinical charts and radiologic data of these patients were reviewed by the first author. Their pain, work, and employment statuses were assessed by the scales proposed by Denis in 1984.
  
  
  RESULTS
  Nine patients were rated P1, 7 were rated P2, 2 were rated P3, 1 was rated P5, 11 were rated W1, 3 were W2, 1 was W3, and 4 were rated W5. Even the physical laborers' return to work averaged 5 months after surgery (range, 3-12 months). The postoperative kyphotic angle ranged from -6 degrees to 45 degrees (average, 11 degrees), and it remained -5 degrees to 45 degrees (average, 12 degrees) at final follow-up. There was no statistical correlation between the kyphotic angle and the pain scale.
  
  
  CONCLUSIONS
  Anterior decompression and stabilization for unstable burst fracture without initial neurologic deficits in the thoracolumbar spine has some advantages in the view of anatomical reduction and rigid stability that allows patients an early rehabilitation, return to work, and gainful employment.
authors.affiliation: Department of Orthopaedic Surgery, Akita University, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Okuyama
authors.forename: E
authors.initials: E
authors.lastname: Abe
authors.forename: M
authors.initials: M
authors.lastname: Chiba
authors.forename: N
authors.initials: N
authors.lastname: Ishikawa
authors.forename: K
authors.initials: K
authors.lastname: Sato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome