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Thoracolumbar burst fractures with a neurological deficit treated with posterior decompression and interlaminar fusion

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Abstract

Introduction

To our knowledge, thoracolumbar burst fractures with a neurological deficit treated with posterior decompression and interlaminar fusion have never been reported. Our study was to assess the outcome of posterior decompression and interlaminar fusion in treating thoracolumbar burst fractures with a neurological deficit.

Materials and methods

Forty-one patients suffering from thoracolumbar burst fractures with a neurological deficit were included this study. All patients were treated with posterior decompression, interlaminar fusion and short-segment fixation of the vertebrae above and below the fracture level and the fractured vertebrae.

Results

All patients were followed up for at least 24 months after surgery. Operative time and blood loss averaged 72 min and 325 ml, respectively. Thirty-eight patients with incomplete neurological lesions improved, by at least one American Spine Injury Association grade, whereas no neurological deterioration was observed in any case. Overall sagittal alignment improved from an average preoperative 22.4°–4.6° kyphosis at the final follow-up observation. The anterior vertebral body height ratio improved from 0.61 before surgery to 0.90 after surgery, whereas posterior vertebral body height ratio improved from 0.90 to 0.95. Spinal canal encroachment was reduced from an average 61.5% before surgery to 8.7% after surgery. Interlaminar radiological fusion was achieved within 6–8 months after surgery. No instrumentation failure was found in any patients.

Conclusion

Posterior decompression, interlaminar fusion with posterior short-segment fixation provided excellent immediate reduction for traumatic segmental kyphosis and significant spinal canal clearance, and restored vertebral body height in the fracture level in patients with a thoracolumbar burst fracture and associated neurological deficit.

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Acknowledgments

This study was supported by Science and Technology Commission of Shanghai Municipality (08411950100).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Wenzhou 2nd People’s Hospital, Wenzhou, Zhejiang, China

    Cheng-Meng Ge

  2. Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China

    Yu-Ren Wang, Sheng-Dan Jiang & Lei-Sheng Jiang

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  1. Cheng-Meng Ge
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  2. Yu-Ren Wang
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Correspondence to Sheng-Dan Jiang or Lei-Sheng Jiang.

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Ge, CM., Wang, YR., Jiang, SD. et al. Thoracolumbar burst fractures with a neurological deficit treated with posterior decompression and interlaminar fusion. Eur Spine J 20, 2195–2201 (2011). https://doi.org/10.1007/s00586-011-1875-6

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  • DOI: https://doi.org/10.1007/s00586-011-1875-6

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