Retroperitioneal Anterior Approach Operation Of Lower Lumbar Fracture With Mini-incision

Objective To investigate the clinical effects of retroperitioneal anterior approach operation of lower lumbar fracture with mini-incision and discuss the surgical technique.Methods Clinical data of 21 cases of serious lower lumbar burst fracture were analyzed retrospectively. The main injured segments were L3 in 10 cases, L4 in 8 cases and L5 in 3 cases. Fracture types according to A0 classification were type A (burst) in 12 cases, type B (distraction) in 2 case and type C (retortion) in 7 cases. All the 21 cases were treated with retroperitioneal anterior decompression, bone graft fusion and internal fixation with mini-incision. The imaging index of preoperation and postoperation as well as neurologic status of preoperation and at the last follow up were compared respectively.Results All the cases had been followed up for an average of 41.9 months (12-86 months). The instant postoperative imaging index showed obvious improvement on the injured body height (from 42.62% preoperatively to 94.33%, P< 0.01) and the canal encroachment index (from 2.67 preoperatively to 0.14, P＜0.01). All those with neurologic deficit were improved above Asia grade one except for 1 cases with complete paraplegia.Conclusion Retroperitioneal anterior decompression and internal fixation with mini-incision are successful in treating serious lower lumbar burst fractures.