Anterior stabilization of three-column thoracolumbar spinal trauma.
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.
Oskouian
Rod J
RJ
Department of Neurological and Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia 22902, USA. rjo2w@virginia.edu
Shaffrey
Christopher I
CI
Whitehill
Richard
R
Sansur
Charles A
CA
Pouratian
Nader
N
Kanter
Adam S
AS
Asthagiri
Ashok R
AR
Dumont
Aaron S
AS
Sheehan
Jason P
JP
Elias
W Jeffrey
WJ
Shaffrey
Mark E
ME
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