Comparative Study About Posterior And Anterior Approach With Subtotal Corpectomy,Decompression,Reconstruction Of Spine,and Internal Fixation For Thoracolumbar Burst Fractures

Objectives:Previously, serious thoracolumbar burst fractures with neurological deficit were treated for through Anterior surgery. In recent years, some surgeons completed subtotal corpectomy, decompression, and reconstruction of spine through the posterior approach and the result was satisfactory. Which approach is better? It remains controversial.To comparatively analyze the clinical effect of posterior and anterior approach with subtotal corpectomy,decompression,reconstruction of spine,and internal fixation for patients with thoracolumbar burst fractures.Methods:The data of 42 patients thoracolumbar burst fracture treated by posterior and anterior posterior approach with subtotal corpectomy, decompression,and reconstruction of spine in our hospital from May 2006 to Dec.2012 was analyzed.They were divided into two groups according to the surgical produres:group A (anterior approach)and group B(posterior approach),group A of 23 cases,group B of 19 cases.During the minimum 24 months follow-up period, all patients were prospectively evaluated for clinical and radiologic outcomes.Results:All patients in this study achieved solid fusion,without hardware failure such as loosening or breakage.The intraoperative blood loss was shorter and the operative time was less in the group B(P<0.05).Complications of operation were less and the pulmonary function after operation was better in the group B (P<0.05).There was a satisfactory results in the two groups.There was no significant difference between two groups about the Frankel scale, VAS, JOA score,anterior height of fractured vertebral and Cobb’s angle at all time points (P>0.05).Conclusions: Anterior approach and posterior approach with subtotal corpectomy, decompression, and reconstruction of spine are sufficient for surgical treatment of thoracolumbar burst fractures.Posterior surgery is a effective and safe surgical method which decreased operation trauma and had shorter operative time, less intraoperative blood loss,less complications and better pulmonary function.