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Modified one-stage posterior/anterior combined surgery with posterior pedicle instrumentation and anterior monosegmental reconstruction for unstable Denis type B thoracolumbar burst fracture

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Abstract

Purpose

This study aimed to evaluate the clinical and radiological results in patients with unstable Denis type B thoracolumbar burst fractures treated by modified one-stage posterior/anterior combined surgery.

Methods

Thirty-one patients with unstable Denis type B thoracolumbar burst fractures were enrolled in this study. The patients underwent one-stage posterior/anterior combined surgery with posterior instrumentation using pedicle screws and anterior monosegmental reconstruction utilizing titanium mesh cages. The mean follow-up period was 38.3 months. Clinical outcomes, radiological parameters, and treatment-related complications were assessed.

Results

The mean age of the patients was 36.4 years. The mean operative time and blood loss were 230 min and 645 ml, respectively. The VAS pain score was significantly improved after surgery, and the improvement was maintained until the final follow-up. In 23 patients with neurologic dysfunction, 20 (87 %) patients had improvement after surgery. By the final follow-up, 27 patients had returned to work; 18 of the 27 patients returned to a similar job. The mean sagittal kyphosis was corrected from 21.2° preoperatively to 2.5° postoperatively, which increased slightly to 4.3° at the final follow-up. Minimal subsidence and tilt of the titanium mesh cage were observed during the follow-up period. Solid bony fusion was achieved in all patients. One patient developed a posterior surgical site infection, which was resolved by antibiotic treatment and surgical debridement.

Conclusion

Modified one-stage posterior/anterior combined surgery for Denis type B unstable thoracolumbar burst fractures can produce good clinical and radiological outcomes.

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Authors and Affiliations

  1. Department of Spinal Surgery, Ningbo No. 6 Hospital, 1059 East Zhongshan Road, Ningbo, 315040, Zhejiang, People’s Republic of China

    Oujie Lai, Yong Hu, Zhenshan Yuan, Xiaoyang Sun, Weixin Dong, Jiao Zhang & Binke Zhu

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  1. Oujie Lai
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  2. Yong Hu
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  3. Zhenshan Yuan
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  4. Xiaoyang Sun
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  5. Weixin Dong
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  6. Jiao Zhang
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  7. Binke Zhu
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Corresponding author

Correspondence to Yong Hu.

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Ethical approval

Ethical approval was obtained from the institutional review board of the Ningbo No. 6 hospital prior to perform this study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Lai, O., Hu, Y., Yuan, Z. et al. Modified one-stage posterior/anterior combined surgery with posterior pedicle instrumentation and anterior monosegmental reconstruction for unstable Denis type B thoracolumbar burst fracture. Eur Spine J 26, 1499–1505 (2017). https://doi.org/10.1007/s00586-016-4800-1

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  • DOI: https://doi.org/10.1007/s00586-016-4800-1

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