title: Posterior/anterior combined surgery for thoracolumbar burst fractures--posterior instrumentation with pedicle screws and laminar hooks, anterior decompression and strut grafting.
abstract: METHODS
  A prospective clinical study.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate prospectively a large group of patients with thoracolumbar burst fractures who were treated with a posterior/anterior combined procedure and to report on the surgical outcomes, complications and radiographic results.
  
  
  METHODS
  A total of 100 consecutive patients were surgically managed with posterior instrumentation, anterior decompression and anterior strut grafting. There were 71 males and 29 females; the mean age was 36 years. Patients with osteoporotic delayed vertebral body collapse were excluded. The mean follow-up period was 30 months. Surgical outcomes such as operative time, blood loss and sagittal alignment were investigated. A neurological assessment was performed by a rating system based on the American Spine Injury Association impairment scale. An interbody fusion was judged using plain X-ray and computed tomographic scans.
  
  
  RESULTS
  The mean operative time was 256 min and the mean operative bleeding was 985 ml. Most of the patients were ambulatory within 3 days after surgery. Of the 76 patients with neurological injury, 54 (71.1%) recovered function following surgery. The mean local kyphosis angle was 12.2° kyphotic preoperatively and 0.8° lordotic at the final observation. The mean correction angle was 15.7° and correction loss was 2.6°. No instrumentation failure was observed and the postoperative fusion rate was 99%.
  
  
  CONCLUSIONS
  Posterior/anterior combined surgery with posterior pedicle screws and hooks fixation, and reconstruction by simultaneous strut grafting and anterior decompression, achieved short segment fixation and can be a useful option for surgically treating thoracolumbar burst fractures.
authors.affiliation: Department of Orthopedic Surgery, Chubu Rosai Hospital, Japan Labor Health and Welfare Organization, Nagoya, Aichi, Japan. masaaki_machino_5445_2@yahoo.co.jp
authors.forename: M
authors.initials: M
authors.lastname: Machino
authors.forename: Y
authors.initials: Y
authors.lastname: Yukawa
authors.forename: K
authors.initials: K
authors.lastname: Ito
authors.forename: H
authors.initials: H
authors.lastname: Nakashima
authors.forename: F
authors.initials: F
authors.lastname: Kato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000592:standards*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D055815:Young Adult