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Tae Sik Goh 1 Article
Treatment of Thoracolumbar and Lumbar Unstable Burst Fractures by Using Combined and Posterior Surgery
Jong Ki Shin, Tae Sik Goh, Seung Min Son, Jung Sub Lee
J Trauma Inj. 2016;29(1):14-21.   Published online March 31, 2016
DOI: https://doi.org/10.20408/jti.2016.29.1.14
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AbstractAbstract PDF
PURPOSE
The purpose of this research was to analyze the results of the combined and posterior approaches for treating thoracolumbar and lumbar burst fractures and to find an adequate method of treatment.
METHODS
We retrospectively analyzed the cases of 46 patients with unstable thoracolumbar and lumbar burst fractures who had been surgically treated. All cases were divided into two groups based on the operation method used. Eleven patients had undergone the combined approach, while 35 patients had undergone the posterior approach. Radiological and clinical evaluations were performed before surgery, after surgery, and at the final follow-up.
RESULTS
The stenotic ratios of the area occupied by the retropulsed bony fragments to the estimated area of the original spinal canal were 68.2% and 45.6% for the combined and the posterior approaches, respectively. No significant differences in the neurological improvement or the corrected state of the sagittal index were noted, but the patients who had been treated with the combined approach group had better results than those who had been treated with the posterior approach group in terms of correction and maintenance of the sagittal index. The average kyphosis corrections at the final follow-up were 15.3 degrees for the patients in the combined approach group and 10.0 degrees for those in the posterior approach group. Surgical time and estimated blood loss were all significantly higher for patients in the combined approach group.
CONCLUSION
The combined and the posterior approaches showed similar results in the improvements of the neurologic state and the corrected state of the sagittal index. However, use of the combined approach is recommended for patients with severe kyphosis and with severe canal encroachment.
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Citations

Citations to this article as recorded by  
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    Anneli Du Plessis, Albert Van Schoor, Quenton Wessels, Patrick Murphy, Francois Van Schouwenburg, Pulenge Ihuhua, Jana Kehrmann, Magda Scholtz, Natalie Keough
    Journal of Anatomy.2022; 240(6): 1179.     CrossRef
  • Minimally invasive reduction of thoracolumbar burst fracture using monoaxial percutaneous pedicle screws: Surgical technique and report of radiological outcome
    Weng Hong Chung, Wei Cheong Eu, Chee Kidd Chiu, Chris Yin Wei Chan, Mun Keong Kwan
    Journal of Orthopaedic Surgery.2020; 28(1): 230949901988897.     CrossRef
  • Differentiation and classification of thoracolumbar transitional vertebrae
    Anneli M. Du Plessis, Linda M. Greyling, Benedict J. Page
    Journal of Anatomy.2018; 232(5): 850.     CrossRef

J Trauma Inj : Journal of Trauma and Injury