Modified one-stage posterior/anterior combined surgery with posterior pedicle instrumentation and anterior monosegmental reconstruction for unstable Denis type B thoracolumbar burst fracture.
This study aimed to evaluate the clinical and radiological results in patients with unstable Denis type B thoracolumbar burst fractures treated by modified one-stage posterior/anterior combined surgery.



Thirty-one patients with unstable Denis type B thoracolumbar burst fractures were enrolled in this study. The patients underwent one-stage posterior/anterior combined surgery with posterior instrumentation using pedicle screws and anterior monosegmental reconstruction utilizing titanium mesh cages. The mean follow-up period was 38.3 months. Clinical outcomes, radiological parameters, and treatment-related complications were assessed.



The mean age of the patients was 36.4 years. The mean operative time and blood loss were 230 min and 645 ml, respectively. The VAS pain score was significantly improved after surgery, and the improvement was maintained until the final follow-up. In 23 patients with neurologic dysfunction, 20 (87 %) patients had improvement after surgery. By the final follow-up, 27 patients had returned to work; 18 of the 27 patients returned to a similar job. The mean sagittal kyphosis was corrected from 21.2° preoperatively to 2.5° postoperatively, which increased slightly to 4.3° at the final follow-up. Minimal subsidence and tilt of the titanium mesh cage were observed during the follow-up period. Solid bony fusion was achieved in all patients. One patient developed a posterior surgical site infection, which was resolved by antibiotic treatment and surgical debridement.



Modified one-stage posterior/anterior combined surgery for Denis type B unstable thoracolumbar burst fractures can produce good clinical and radiological outcomes.
Department of Spinal Surgery, Ningbo No. 6 Hospital, 1059 East Zhongshan Road, Ningbo, 315040, Zhejiang, People's Republic of China.
Oujie
O
Lai
Department of Spinal Surgery, Ningbo No. 6 Hospital, 1059 East Zhongshan Road, Ningbo, 315040, Zhejiang, People's Republic of China. huyong610@163.com.
Yong
0000-0002-6515-2772
Y
Hu
Department of Spinal Surgery, Ningbo No. 6 Hospital, 1059 East Zhongshan Road, Ningbo, 315040, Zhejiang, People's Republic of China.
Zhenshan
Z
Yuan
Department of Spinal Surgery, Ningbo No. 6 Hospital, 1059 East Zhongshan Road, Ningbo, 315040, Zhejiang, People's Republic of China.
Xiaoyang
X
Sun
Department of Spinal Surgery, Ningbo No. 6 Hospital, 1059 East Zhongshan Road, Ningbo, 315040, Zhejiang, People's Republic of China.
Weixin
W
Dong
Department of Spinal Surgery, Ningbo No. 6 Hospital, 1059 East Zhongshan Road, Ningbo, 315040, Zhejiang, People's Republic of China.
Jiao
J
Zhang
Department of Spinal Surgery, Ningbo No. 6 Hospital, 1059 East Zhongshan Road, Ningbo, 315040, Zhejiang, People's Republic of China.
Binke
B
Zhu
D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D065289:Pedicle Screws; D011183:Postoperative Complications; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000706:statistics & numerical data; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery
Anterior monosegmental reconstruction; Posterior instrumentation; Posterior/anterior combined surgery; Thoracolumbar burst fracture