Anterolateral Approach for Unstable Lumbar Burst Fracture with Anterior Compression
Anterolateral Approach for Unstable Lumbar Burst Fracture with Anterior Compression作者机构:Department of Neurosurgery Al-Azhar University Hospitals Cairo Egypt
出 版 物:《Open Journal of Modern Neurosurgery》 (现代神经外科学进展(英文))
年 卷 期:2018年第8卷第2期
页 面:201-214页
学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
摘 要:Background: Lumbar burst fractures are common spinal injuries that cause severe instability with kyphotic deformities and neurological complications requiring surgical decompression and reconstruction with spinal instrumentation for unstable burst fracture, but there is controversy about the optimal surgical approach anterior, posterior or combined approach. Objectives: To assess the efficacy & safety of anterolateral approach in decompression and reconstruction with spinal instrumentation for lumbar burst fractures. Subjects & Methods: A retrospective study including 16 patients, 10 males and 6 females with lumbar burst fractures and anterior compression treated operatively by anterolateral approach for corpectomy and single level fusion by using expandable cage or mesh cage loaded with bone graft and plat with screws. The clinical and radiological follow up after discharge from the hospital ranged from 12 to 24 months. Results: All patients improved regarding the Frankel score more than one grade after surgery, except 2 cases of grade A didn’t improve. Mean preoperative visual analogue scale was 7.4 improving to 0.9 postoperatively. The mean Local kyphosis improved from 8.8° before surgery to -1° after surgery. Conclusions: Anterolateral approach is feasible, effective, and safe approach for unstable lumbar burst fractures. Angular deformity is successfully corrected when the anterior approach is used.