Anterior decompression with single segmental spinal interbody fusion for Denis type B thoracolumbar burst fracture: a midterm follow-up study

Abstract

Purpose Our goal was to observe the midterm results of a case series of Denis type B thoracolumbar burst fracture treated with anterior decompression with single segmental spinal Interbody fusion. Methods Twenty patients with Denis type B thoracolumbar burst fractures underwent anterior decompression with single segmental spinal Interbody fusion. They underwent clinical and radiologic follow-up for at least three years after the surgery. Results The mean follow-up period lasted 57 months. To the last follow-up, there were no cases of internal fixation loosening, failure and other complications. Titanium mesh or interbody bone grafts were in good position. Spinal kyphosis was not observed. Interbody fusion was achieved for all cases. The average fusion time was 4.5 months. Based on visual analogue scale (VAS) pain scores, percentage of vertebral body height loss and Cobb angle, the difference was statistically significant between the preoperative period and postoperative one year or final follow-up (P <0.05). Results at postoperative one year and final follow-up were better than the preoperative period. However, the difference was not significant between postoperative one year and final follow-up (P >0.05). Conclusions Good midterm results on clinical and radiologic evaluation of anterior decompression with single segmental spinal Interbody fusion for suitable patients with Denis type B thoracolumbar burst fracture can be achieved. The incident rate of relative complications is low.

Early results of thoraco lumbar burst fracture treatment using selective corpectomy and rectangular cage reconstruction

“…In the current study, burst level fusion reached 83.3% at 3 months after surgery and 98.3% at 6 months, which is suggestive of early and excellent fusion. According to the previous anterior surgery study, 13 18 the average fusion time was about 4.5 months. However, they have not clearly mentioned the exact fusion rate during their followup period which made it hard to compare with our results.…”

Postoperative loss of correction after combined posterior and anterior spinal fusion surgeries in a lumbar burst fracture patient with Class II obesity

“…A favorable surgical outcome of single-level anterior fusion was reported in patients with thoracolumbar burst fracture in which the cranial endplate is mainly involved and the caudal endplate has no or slight injury. [ 12 , 15 , 21 ] A previous study showed that postoperative correction loss was not significantly different between single-level and two-level anterior fusion surgery in such patients. [ 17 ] Miyakoshi et al .…”

A new decompression technique for upper lumbar fracture with neurologic deficit-comparison with traditional open posterior surgery

“…Anterior approaches can achieve complete removal of the retropulsed bone and soft tissue fragments from the spinal canal under direct visualization without manipulation of the dural tube, as well as anterior reconstruction using plate or rod with bone graft [25]. Theoretically, the anterior approach offers a satisfactory canal decompression and a better chance of neurologic improvement compared to other procedures [25]. However, this approach is surgically challenging and more likely to have complications due to the adjacent chest and abdominal organs as well as major blood vessels [7].…”