title: Minimally invasive transforaminal interbody fusion surgery for the old fracture of the thoracolumbar junction.
abstract: METHODS
  Retrospective analysis of the clinical outcomes of 15 patients with the old thoracolumbar junction fracture treated by minimally invasive surgery (MIS) transforaminal interbody fusion surgery.
  
  
  OBJECTIVE
  To investigate the efficacy and safety of MIS for the old fracture of the thoracolumbar junction in a pilot study.
  
  
  BACKGROUND
  MIS have demonstrated efficacy in the treatment of lumbar degenerative diseases. There is some controversy regarding the ideal management of thoracolumbar fractures, especially those without an associated neurologic deficit. Reports concerning MIS for old thoracolumbar junction fracture with chronic pain are quite rare.
  
  
  METHODS
  A total of 15 MIS fusion, performed between October 2006 and May 2011, were examined in a retrospective study. The clinical and radiological data were collected and analyzed. Fusion levels were T10–T11 (2 patients), T11–T12 (5 patients), T12–L1 (6 patients), L1–L2 (2 patients). Clinical outcome was assessed using the visual analogue scale and the Oswestry disability index. Radiographic evaluation of the lumbar spine was performed at the second day and 12 months postoperatively.
  
  
  RESULTS
  The average follow-up period was 26.3 months, with a minimum of 17 months. The mean operating time, intraoperative blood loss, and x-ray exposure time were 125±31 minutes, 226±45 mL, and 47±12 seconds, respectively. At last followup,the visual analogue scale for back pain and the Oswestry disability index decreased significantly postoperatively from 7.4±2.3 to 1.8±0.6 (P<0.01) and from 38.9±7.1 to 13.5±4.5 (P<0.01), respectively. The average Cobb angle was improved from 19.1–15.1 degrees in this series. No significant correction of local kyphosis was found postoperatively (P>0.05). Radiographic evaluation showed satisfactory bony union at the fixed level in all cases except for 2 patients. There were no other major complications at last follow-up.
  
  
  CONCLUSIONS
  MIS transforaminal interbody fusion is a safe and effective procedure for old thoracolumbar junction fracture with chronic pain. Improvement of kyphosis is limited and occurrence of nonunion is relatively high.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhou
authors.forename: Zheng Feng
authors.initials: ZF
authors.lastname: Zhang
authors.forename: Chang Qing
authors.initials: CQ
authors.lastname: Li
authors.forename: Wen Jie
authors.initials: WJ
authors.lastname: Zheng
authors.forename: Bo
authors.initials: B
authors.lastname: Huang
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011182:Postoperative Care; D011300:Preoperative Care; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed