Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures

Patrick W Hitchon; James Torner; Kurt M Eichholz; Stephanie N Beeler

doi:10.3171/spi.2006.5.2.117

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$Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures$

Journal article

Peer reviewed

Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures

Patrick W Hitchon, James Torner, Kurt M Eichholz and Stephanie N Beeler

Journal of neurosurgery. Spine, Vol.5(2), pp.117-125

08/2006

DOI: 10.3171/spi.2006.5.2.117

PMID: 16925077

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Abstract

The authors undertook a retrospective cohort study of patients with T11-L2 thoracolumbar burst fractures who underwent decompression and the placement of instrumentation via the anterolateral or posterior approach. There were 63 thoracolumbar burst fractures in 45 male and 18 female patients. The instrumentation was placed posteriorly in 25 patients and anterolaterally in 38. The mean follow-up duration after discharge from the hospital was 1.8 years (range 6 months-8 years). The mean preoperative Frankel scores in the anterolateral and posterior groups were 3.7 +/- 1.1 and 3.5 +/- 1.4, respectively (p = 0.4155). Preoperative angular deformity in the anterolateral and posterior groups measured 11.9 +/- 9.7 and 4.1 +/- 7.1 degrees, respectively (p = 0.0007). Postoperatively, angular deformity had been corrected to 2.0 +/- 7.9 and 3.4 +/- 7.5 degrees in both groups, respectively (p = 0.565). The follow-up Frankel scores had improved to 4.2 +/- 0.8 and 4.0 +/- 1.4 (p = 0.461). At the latest follow-up examination, angular deformity had progressed to 4.5 +/- 9.3 degrees in the anterolateral group and to 9.8 +/- 9.4 degrees in the posterior group (p = 0.024). dollar 18,270 +/- 6980), there was no intergroup difference in total cost of hospitalization. Rigid guidelines for the selection of anterior or posterior approaches are lacking. Evaluation of the authors' results and those of others shows that angular deformity is more successfully corrected and maintained when the anterior approach is used.

Length of Stay

Spinal Fusion - methods

Thoracic Vertebrae - diagnostic imaging

Lumbar Vertebrae - injuries

Follow-Up Studies

Lumbar Vertebrae - diagnostic imaging

Humans

Middle Aged

Spinal Fractures - surgery

Male

Spinal Fractures - diagnostic imaging

Radiography

Spinal Fusion - economics

Thoracic Vertebrae - surgery

Health Care Costs

Lumbar Vertebrae - surgery

Spinal Fractures - economics

Adult

Female

Retrospective Studies

Postoperative Complications

Thoracic Vertebrae - injuries

Details

Title: Subtitle: Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures
Creators: Patrick W Hitchon - Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa 52240, USA. patrick-hitchon@uiowa.edu
James Torner
Kurt M Eichholz
Stephanie N Beeler
Resource Type: Journal article
Publication Details: Journal of neurosurgery. Spine, Vol.5(2), pp.117-125
DOI: 10.3171/spi.2006.5.2.117
PMID: 16925077
NLM abbreviation: J Neurosurg Spine
ISSN: 1547-5654
eISSN: 1547-5646
Publisher: American Association of Neurological Surgeons; United States
Language: English
Date published: 08/2006
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9983996190702771

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