title: Posterior transpedicular decompression for thoracolumbar burst fractures.
abstract: OBJECTIVE
  To demonstrate the feasibility of spinal canal decompression through the posterior transpedicular approach in patients with thoracolumbar burst fractures.
  
  
  METHODS
  We present 25 consecutive patients (19 men and 6 women; mean age 36 years; age range, 24-48 years) with incomplete neurological deficits (ASIA B and C) resulting from thoracolumbar burst fractures treated by posterior transpedicular spinal canal decompression and posterior segmental instrumented fusion. Canal compromise at presentation was 51.7 +/- 11.2%.
  
  
  RESULTS
  The mean surgical time was 122 minutes (range, 108-122 minutes), and the mean blood loss was 528 +/- 123 ml. Canal compromise improved to 15.3 +/- 7.8%. At a mean followup of 14 months (range, 6-18 months), fourteen patients improved to ASIA D and were able to walk with an orthosis; seven improved to ASIA C, and four had no improvement (ASIA B). Seven ASIA B and all ASIA C patients had immediate postoperative neurological improvement to ASIA C and ASIA D; two ASIA B patients improved to ASIA C within six weeks after the operation. Anterior decompression was necessary in two (8%) ASIA B patients who did not improve after the initial operation; these patients, subsequently improved to ASIA C. There were no intraoperative complications. Superficial wound infections occurred in two patients and were treated with wound care and antibiotics; deep infection occurred in one patient and was treated with debridement and antibiotics.
  
  
  CONCLUSIONS
  Posterior transpedicular spinal canal decompression and instrumentation is a reasonable alternative technique to anterior decompression procedures and circumferential fusion, providing for satisfactory canal decompression and neurological improvement.
authors.affiliation: The First, Athens University Medical School, Athens, Greece. andreasfmavrogenis@yahoo.com
authors.forename: Andreas
authors.initials: A
authors.lastname: Mavrogenis
authors.forename: Haridimos
authors.initials: H
authors.lastname: Tsibidakis
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Papagelopoulos
authors.forename: Dimitris
authors.initials: D
authors.lastname: Antonopoulos
authors.forename: Jannis
authors.initials: J
authors.lastname: Papathanasiou
authors.forename: Demetrios
authors.initials: D
authors.lastname: Korres
authors.forename: Spyros
authors.initials: S
authors.lastname: Pneumaticos
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016103:Spinal Fractures / Q000503:physiopathology* / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000293:injuries*; D016896:Treatment Outcome