Comparison of three different surgical approaches for treatment of thoracolumbar burst fracture  

作　　者：WU Han WANG Chun-xin GU Chang-yue ZHANG Zi-yan TONG Shen YAN Hua-dong WANG Jin-cheng 

机构地区：[1]Department of Orthopedic Surgery, China-Japan UnionHospital of Jilin University, Changchun 130033, China

出　　处：《Chinese Journal of Traumatology》2013年第1期31-35,共5页中华创伤杂志（英文版）

基　　金：This research was supported by the National Natural Science Foundation of China （No.30772209）.

摘　　要：Objective： The main treatment method used for thoracolumbar fractures is open reduction and in- ternal fixation. Commonly there are three surgical approaches： anterior, posterior and paraspinal. We attempt to compare the three approaches based on our clinical data analysis. Methods： A group of 94 patients with Denis type A or B thoracolumbar burst fracture between March 2008 and September 2010 were recruited in this study. These patients were treated by anterior-, posterioror paraspinal-approach reduction with or without decompression. The fracture was fixed with titanium mesh and Z-plate via anterior approach （24 patients）, screw and rod system via posterior approach （38 patients） or paraspinal approach （32 patients）. Clinical evaluations included operation duration, blood loss, inci- sion length, preoperative and postoperative Oswestry disability index （ODI）. Results： The average operation duration （94.1 min±13.7 rain）, blood loss （86.7 ml-20.0 ml）, length of incision （9.3 mm± 0.7 mm） and postoperative ODI （6±0.5） were significantly lower （P〈0.05） in paraspinal approach group than in traditional posterior approach group （operation duration 94.1 min±13.7 min, blood loss 143.3 ml±28.3 ml, length of incision 15.4 cm±2.1 cm and ODI 12±0.7） and anterior approach group （operation duration 176.3 min±20.7 min, blood loss 255.1 ml±38.4 mt, length of incision 18.6 cm±2.4 cm and ODI 13±2.4）. There was not statistical difference in terms of Cobb angle on radiographs among the three approaches. Conclusion： The anterior approach surgery is conve- nient for resection of the vertebrae and reconstruction of vertebral height, but it is more complicated and traumatic. Hence it is mostly used for severe Denis type B fracture. The posterior approach is commonly applied to most thoracolumbar fractures and has fewer complications compared with the anterior approach, but it has some shortcomings as well. The paraspinal approach has great advantages compared with the

关 键 词：Thoracic vertebrae Lumbar vertebrae Fractures  bone Surgical procedures  operative SPINE 

分 类 号：S858.292[农业科学—临床兽医学] S857.164[农业科学—兽医学]