Abstract
The principal objectives in the treatment of thoracolumbar burst fractures are the adequate decompression of the spinal canal to maximize neurologic recovery and the creation of spinal stability to prevent painful deformity and potential future neurologic deterioration. Anterior/posterior combined surgery consists of posterior short segmental fixation with pedicle screws and hooks followed by anterior decompression with strut graft reconstruction. This procedure provides both optimal decompression and rigid fixation, through two separate skin incisions. This chapter introduces combined posterior–anterior surgery in the treatment of thoracolumbar burst fractures and describes its indications, procedural steps, technical pitfalls, and postoperative course in detail.
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References
Bradford DS, McBride GG (1987) Surgical management of thoracolumbar spine fractures with incomplete neurologic deficits. Clin Orthop Relat Res 218:201–216
Chiba M, McLain RF, Yerby SA, Moseley TA, Smith TS, Benson DR (1996) Short-segment pedicle instrumentation. Biomechanical analysis of supplemental hook fixation. Spine 21(3):288–294
Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8(8):817–831
Ebelke DK, Asher MA, Neff JR, Kraker DP (1991) Survivorship analysis of VSP spine instrumentation in the treatment of thoracolumbar and lumbar burst fractures. Spine 16(8 Suppl):S428–S432
Gertzbein SD, Court-Brown CM, Jacobs RR, Marks P, Martin C, Stoll J, Fazl M, Schwartz M, Rowed D (1988) Decompression and circumferential stabilization of unstable spinal fractures. Spine 13(8):892–895
Hashimoto T, Kaneda K, Abumi K (1988) Relationship between traumatic spinal canal stenosis and neurologic deficits in thoracolumbar burst fractures. Spine 13(11):1268–1272
Kaneda K, Taneichi H, Abumi K, Hashimoto T, Satoh S, Fujiya M (1997) Anterior decompression and stabilization with the Kaneda device for thoracolumbar burst fractures associated with neurological deficits. J Bone Joint Surg Am 79(1):69–83
Kostuik JP (1988) Anterior fixation for burst fractures of the thoracic and lumbar spine with or without neurological involvement. Spine 13(3):286–293
McAfee PC, Bohlman HH, Yuan HA (1985) Anterior decompression of traumatic thoracolumbar fractures with incomplete neurological deficit using a retroperitoneal approach. J Bone Joint Surg Am 67(1):89–104
Schwartz DM (2003) Intraoperative neurophysiological monitoring during post-traumatic spine surgery. In: Vaccaro AR (ed) Fractures of the cervical, thoracic and lumbar spine. Marcel Dekker, New York, pp 373–383
Shiba K, Katsuki M, Ueta T, Shirasawa K, Ohta H, Mori E, Rikimaru S (1994) Transpedicular fixation with Zielke instrumentation in the treatment of thoracolumbar and lumbar injuries. Spine 19(17):1940–1949
Yukawa Y, Kato F, Ito K et al (2006) Anteroposterior combined surgery for thoracolumbar burst fractures – anterior decompression, strut-grafting and posterior instrumentation with pedicle screws and laminar hook. Paper presented at ASIA-ISCoS Combined Meeting, Boston, USA, 25–28 June 2006
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Yukawa, Y. (2010). Anterior and Posterior Surgery and Fixation for Burst Fractures. In: Patel, V., Burger, E., Brown, C. (eds) Spine Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03694-1_26
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DOI: https://doi.org/10.1007/978-3-642-03694-1_26
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