Surgical Management of Unstable Thoracolumbar Burst Fractures: Anterior Versus Posterior Surgery

2013 ◽  
Vol 02 (05) ◽  
Author(s):  
Tarek Aly
Keyword(s):  
Surgical Management ◽  
Thoracolumbar Burst Fractures ◽  
Posterior Surgery ◽  
Burst Fractures

Surgical Management of Thoracolumbar Burst Fractures

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Patrick B. Morrissey ◽  
Karim A. Shafi ◽  
Scott C. Wagner ◽  
Joseph S. Butler ◽  
Ian D. Kaye ◽  
...  
Keyword(s):  
Surgical Management ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures

scholarly journals Combined Anterior-Posterior Surgery Versus Posterior Surgery for Thoracolumbar Burst Fractures: A Systematic Review of the Literature

2010 ◽  
Vol 4 (1) ◽  
pp. 93-100 ◽  
Author(s):  
Pim P. Oprel ◽  
Wim E Tuinebreijer ◽  
Peter Patka ◽  
Dennis den Hartog
Keyword(s):  
Posterior Approach ◽  
Randomized Clinical Trials ◽  
Burst Fracture ◽  
Cochrane Central Register ◽  
Review Of The Literature ◽  
Thoracolumbar Burst Fractures ◽  
Posterior Surgery ◽  
Burst Fractures ◽  
Posterior Group ◽  
Anterior Posterior

Study Design: A systematic quantitative review of the literature. Objective: To compare combined anterior-posterior surgery versus posterior surgery for thoracolumbar fractures in order to identify better treatments. Summary of Background Data: Axial load of the anterior and middle column of the spine can lead to a burst fracture in the vertebral body. The management of thoracolumbar burst fractures remains controversial. The goals of operative treatment are fracture reduction, fixation and decompressing the neural canal. For this, different operative methods are developed, for instance, the posterior and the combined anterior-posterior approach. Recent systematic qualitative reviews comparing these methods are lacking. Methods: We conducted an electronic search of MEDLINE, EMBASE, LILACS and the Cochrane Central Register for Controlled Trials. Results: Five observational comparative studies and no randomized clinical trials comparing the combined anteriorposterior approach with the posterior approach were retrieved. The total enrollment of patients in these studies was 755 patients. The results were expressed as relative risk (RR) for dichotomous outcomes and weighted mean difference (WMD) for continuous outcomes with 95% confidence intervals (CI). Conclusions: A small significantly higher kyphotic correction and improvement of vertebral height (sagittal index) observed for the combined anterior-posterior group is cancelled out by more blood loss, longer operation time, longer hospital stay, higher costs and a possible higher intra- and postoperative complication rate requiring re-operation and the possibility of a worsened Hannover spine score. The surgeons’ choices regarding the operative approach are biased: worse cases tended to undergo the combined anterior-posterior approach.

Meta-Analysis of Anterior Surgery versus Posterior Surgery for Thoracolumbar Burst Fractures

2016 ◽  
Vol 13 (1) ◽  
pp. 678-687
Author(s):  
YuWen Jiang ◽  
Hong Xia ◽  
HaiFeng Liu ◽  
QiuGen Hu ◽  
Guang Zheng ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Anterior Surgery ◽  
Thoracolumbar Burst Fractures ◽  
Posterior Surgery ◽  
Burst Fractures

Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures

2006 ◽  
Vol 5 (2) ◽  
pp. 117-125 ◽  
Author(s):  
Patrick W. Hitchon ◽  
James Torner ◽  
Kurt M. Eichholz ◽  
Stephanie N. Beeler
Keyword(s):  
Angular Deformity ◽  
Intergroup Difference ◽  
Total Cost ◽  
Thoracolumbar Burst Fractures ◽  
Posterior Surgery ◽  
Burst Fractures ◽  
Posterior Group ◽  
The Mean ◽  
Selection Of

Object The authors undertook a retrospective cohort study of patients with T11–L2 thoracolumbar burst fractures who underwent decompression and the placement of instrumentation via the anterolateral or posterior approach. Methods There were 63 thoracolumbar burst fractures in 45 male and 18 female patients. The instrumentation was placed posteriorly in 25 patients and anterolaterally in 38. The mean follow-up duration after discharge from the hospital was 1.8 years (range 6 months–8 years). The mean preoperative Frankel scores in the anterolateral and posterior groups were 3.7 ± 1.1 and 3.5 ± 1.4, respectively (p = 0.4155). Preoperative angular deformity in the anterolateral and posterior groups measured 11.9 ± 9.7 and 4.1 ± 7.1°, respectively (p = 0.0007). Postoperatively, angular deformity had been corrected to 2.0 ± 7.9 and 3.4 ± 7.5° in both groups, respectively (p = 0.565). The follow-up Frankel scores had improved to 4.2 ± 0.8 and 4.0 ± 1.4 (p = 0.461). At the latest follow-up examination, angular deformity had progressed to 4.5 ± 9.3° in the anterolateral group and to 9.8 ± 9.4° in the posterior group (p = 0.024). Although surgeons’ fees were significantly (p = 0.0024) higher for patients who underwent anterolateral procedures ($27,940 ± 4390) than for those who underwent posterior surgery ($18,270 ± 6980), there was no intergroup difference in total cost of hospitalization. Conclusions Rigid guidelines for the selection of anterior or posterior approaches are lacking. Evaluation of the authors’ results and those of others shows that angular deformity is more successfully corrected and maintained when the anterior approach is used.

Surgical approaches for the correction of unstable thoracolumbar burst fractures: a retrospective analysis of treatment outcomes

1995 ◽  
Vol 83 (6) ◽  
pp. 977-983 ◽  
Author(s):  
Olumide A. Danisa ◽  
Christopher I. Shaffrey ◽  
John A. Jane ◽  
Richard Whitehill ◽  
Gwo-Jaw Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Neurological Function ◽  
Surgical Approaches ◽  
Content Type ◽  
Thoracolumbar Burst Fractures ◽  
Posterior Surgery ◽  
Treatment Groups ◽  
Burst Fractures ◽  
Anterior Decompression And Fusion ◽  
Anterior Posterior

✓ The authors retrospectively studied 49 nonparaplegic patients who sustained acute unstable thoracolumbar burst fractures. All patients underwent surgical treatment and were followed for an average of 27 months. All but one patient achieved solid radiographic fusion. Three treatment groups were studied: the first group of 16 patients underwent anterior decompression and fusion with instrumentation; the second group of 27 patients underwent posterior decompression and fusion; and the third group of six patients had combined anterior—posterior surgery. Prior to surgical intervention, these groups were compared and found to be similar in age, gender, level of injury, percentage of canal compromise, neurological function, and kyphosis. Patients treated with posterior surgery had a statistically significant diminution in operative time and blood loss and number of units transfused. There were no significant intergroup differences when considering postoperative kyphotic correction, neurological function, pain assessment, or the ability to return to work. Posterior surgery was found to be as effective as anterior or anterior—posterior surgery when treating unstable thoracolumbar burst fractures. Posterior surgery, however, takes the least time, causes the least blood loss, and is the least expensive of the three procedures.

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