title: [One-stage posterior approach spinal reconstruction for severe lumbar burst fracture].
abstract: OBJECTIVE
  To evaluate the clinical therapeutic outcomes for severe burst fracture of lumbar vertebrae via a posterior approach for one-stage spinal "three-column" reconstruction.
  
  
  METHODS
  An retrospective analysis of data was performed for 21 patients with severe burst fracture of lumbar vertebrae undergoing a posterior approach for one-stage spinal "three-column" reconstruction from 2005 to 2010. It was compared with previous 15 cases undergoing a staged anteroposterior approach. The operative duration, volume of blood loss, pre- and post-operative imaging measurements of kyphosis and vertebral height and nerve function recovery were evaluated.
  
  
  RESULTS
  The values of operative duration and volume of blood loss in the one-stage posterior approach group were significantly less than those of the two-stage anteroposterior approach group [(263 ± 72) min vs (439 ± 75) min, t = -5.303, P < 0.01; (1143 ± 296) ml vs (1471 ± 399) ml, t = -2.169, P = 0.042)]. Statistical significance existed in postoperative kyphosis between two groups [(0.5 ± 2.0)° vs (3.9 ± 2.6)°, t = -3.336, P = 0.003]. Vertebral height had no statistical significance pre- and post-operatively between two groups while restoration of vertebral height did [(0.47 ± 0.19) mm vs (0.26 ± 0.15) mm, t = 2.669, P = 0.015].
  
  
  CONCLUSIONS
  Posterior approach for one-stage vertebral resection, mesh implantation, pedicle screws and rod internal fixation for reconstructing spinal "three-column" structures offers excellent feasibility and safety. And it may avoid complications associated with an anteroposterior approach for two-stage procedures. The median length of hospital stay is also reduced.
authors.affiliation: Department of Spinal Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Mao
authors.forename: Wei
authors.initials: W
authors.lastname: Tian
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.forename: Qin
authors.initials: Q
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Hu
authors.forename: Gui-Lin
authors.initials: GL
authors.lastname: Zhang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Yuan
authors.forename: Yong-Gang
authors.initials: YG
authors.lastname: Xing
authors.forename: Xiao Bin
authors.initials: XB
authors.lastname: Xing
authors.forename: Zhao
authors.initials: Z
authors.lastname: Lang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*