title: Anterior stabilization of three-column thoracolumbar spinal trauma.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the results obtained in patients who underwent anterior stabilization for three-column thoracolumbar fractures.
  
  
  METHODS
  The authors retrospectively reviewed available clinical and radiographic data (1997-2006) to classify three-column thoracolumbar fractures according to the Association for the Study of Internal Fixation (AO) system, neurological status, spinal canal compromise, pre- and postoperative segmental angulation, and arthrodesis rate. The mean computed tomography-measured preoperative spinal canal compromise was 48.3% (range 8-92%), and the mean vertebral body height loss was 39.4%. The mean preoperative kyphotic deformity of 14.9 degrees improved to 4.6 degrees at the final follow-up examination. Although this angulation had increased a mean of 1.8 degrees during the follow-up period, the extent of correction was still significant compared with the preoperative angulation (p < 0.01). There were no cases of vascular complication or neurological deterioration.
  
  
  CONCLUSIONS
  Contemporary anterior spinal reconstruction techniques can allow certain types of unstable three-column thoracolumbar fractures to be treated via an anterior approach alone. Compared with traditional posterior approaches, the anterior route spares lumbar motion segments and obviates the need for harvesting of the iliac crest.
authors.affiliation: Department of Neurological and Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia 22902, USA. rjo2w@virginia.edu
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Oskouian
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Shaffrey
authors.forename: Richard
authors.initials: R
authors.lastname: Whitehill
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sansur
authors.forename: Nader
authors.initials: N
authors.lastname: Pouratian
authors.forename: Adam S
authors.initials: AS
authors.lastname: Kanter
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Asthagiri
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Dumont
authors.forename: Jason P
authors.initials: JP
authors.lastname: Sheehan
authors.forename: W Jeffrey
authors.initials: WJ
authors.lastname: Elias
authors.forename: Mark E
authors.initials: ME
authors.lastname: Shaffrey
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D016268:Internal Fixators; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D017116:Low Back Pain / Q000209:etiology / Q000517:prevention & control; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries*; D016896:Treatment Outcome