Anterior Spinoplasty For The Treatment Of Thoracolumbar Burst Fractures

ObjectiveTo study the clinical value of spinoplasty for treating of fresh thoracolumbar burst fractures. MethodsBetween January 1998 and December 2000, 28 consecutive patients with fresh thoracolumbar burst fracture were treated by anterolateral decompression, bony endplate preservation interbody fusion with tricoitical iliac crest graft or titanium surgical mesh (TSM)-bone graft composite, and internal fixation with Z-plate. The ASIA grade of neurologic function, the kyphosis angle, height of compressed vertebral bodies, and computed tomographic evaluation of the cross-canal area were evaluated preoperatively and postoperatively. ResultsThe average follow-up was 13 months (range, 6-25 months). Neurologic function: A,0 cases, B, 7 cases, c, 11 cases, D, 8 cases, E, 2 cases before surgery, and A,0 cases, B, 0 cases, c, 5 cases, D, 11 cases, E, 12 cases aftersurgery, respectively. Improvement of neurologic function of more than one ASIA grade occurred in %(27/28) of patients. Kyphotic deformity was corrected from 28.5 degrees before surgery to 6.5 degrees after surgery, height of compressed vertebral bodies was restored from 45.5% to 97.6% of the normal height Computed tomographic evaluation showed that the cross-canal area was restored from 41.8% preoperatively to 99% postoperatively. There was no dislocation of implant, and nonunion of bone graft, all patients maintained their postoperative sagittal alignment or a significant portion of their kyphosis reduction. There were no neurologic or perioperative complications, or hardware failure. ConclusionThe complete, reliable and high quality provided by anterolateral decompression, and the stability and sufficient rigidity of anterior and middle columns yielded by bony endplate preservation interbody fusion and internal fixation with Z-plate support that anterior spinoplasty may be an alternative method for treatment of thoracolumbar burst fractures.