One Stage Anterior Reconstruction and Posterior Instrumentation in Surgical Management of Thoracolumbar Spine Fractures
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Author(s)
ABSTRACT
Background:
The different methods of anterior reconstruction and posterior
instrumentation in surgical management of thoracolumbar spine fractures
are PLIF, TLIF, lateral extracaviatary and transpedicular techniques
which are increasingly used to perform partial or total corpectomies and
anterior reconstructions from a posterior approach. These techniques
were being alternative to the standard anterior approach with less
morbidity and mortality. Patients and Methods: This study was performed
between 2011 and 2014 on 100 patients with acute unstable thoracolumbar
spine fractures which were divided into four groups: 30 patients
underwent (TLIF), 28 patients underwent (PLIF), 28 patients underwent
(PA) and 14 patients underwent (TPA). Neurological outcome,
complications, operative times, kyphotic angle, vertebral height loss,
spinal canal compromise, pulmonary functions, Denis pain and work scale,
VAS score, ODI score, hospital stay, and estimated blood loss (EBL)
were evaluated and compared in between the four groups. Results: There
was a higher complication rate, increased EBL, and longer operative time
with posteroanterior (PA) compared with PLIF, TLIF and (TPA). Patients
undergoing PLIF, TLIF and TPA had a greater recovery of neurological
function than those in whom PA were performed. Conclusion: TPA appeared
to have more favorable results in improving the clinical and
radiological outcome and no complications were reported apart from
superficial wound infection which healed rapidly. The PLIF, TLIF and TPA
appeared to have a comparable morbidity rate to PA. The different
methods of anterior reconstruction from posterior approach are more
favorable, applicable and convenient than PA approach.
KEYWORDS
Transpedicular Approach (TPA), Postero-Anterior Approach (PA), Posterior Lumbar Interbody Fusion (PLIF), Transforminal Lumbar Interbody Fusion (TLIF)
Cite this paper
References
Omran,
K. , Ali, H. , Saleh, A. , Omar, A. , Elhawery, I. and Alkhooly, A.
(2015) One Stage Anterior Reconstruction and Posterior Instrumentation
in Surgical Management of Thoracolumbar Spine Fractures. Open Journal of Orthopedics, 5, 6-15. doi: 10.4236/ojo.2015.51002.
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