Surgical treatment of Denis type B thoracolumbar burst fracture with neurological deficiency by paraspinal approach

• Published in: Brazilian journal of medical and biological research 2016-01, Vol.49 (11), p.e5599-e5599
• Main Authors: Wu, H, Zhao, D-X, Jiang, R, Zhou, X-Y
• Format: Article
• Language: English
• Subjects: Adult; Aged; BIOLOGY; Biomedical Sciences; Fracture Fixation, Internal - methods; Humans; Internal fixation; Lumbar Vertebrae - injuries; Medical research; MEDICINE, RESEARCH & EXPERIMENTAL; Methods; Middle Aged; Neurological deficiency; Paraspinal approach; Paraspinal Muscles - injuries; Patient outcomes; Spinal Fractures - surgery; Surgery treatment; Thoracic Vertebrae - injuries; Thoracolumbar burst fracture; Treatment Outcome; Young Adult
• ISSN: 0100-879X; 1414-431X; 1414-431X
• DOI: 10.1590/1414-431X20165599

We aimed to describe the surgical technique and clinical outcomes of paraspinal-approach reduction and fixation (PARF) in a group of patients with Denis type B thoracolumbar burst fracture (TLBF) with neurological deficiencies. A total of 62 patients with Denis B TLBF with neurological deficiencies were included in this study between January 2009 and December 2011. Clinical evaluations including the Frankel scale, pain visual analog scale (VAS) and radiological assessment (CT scans for fragment reduction and X-ray for the Cobb angle, adjacent superior and inferior intervertebral disc height, and vertebral canal diameter) were performed preoperatively and at 3 days, 6 months, and 1 and 2 years postoperatively. All patients underwent successful PARF, and were followed-up for at least 2 years. Average surgical time, blood loss and incision length were recorded. The sagittal vertebral canal diameter was significantly enlarged. The canal stenosis index was also improved. Kyphosis was corrected and remained at 8.6±1.4o (P>0.05) 1 year postoperatively. Adjacent disc heights remained constant. Average Frankel grades were significantly improved at the end of follow-up. All 62 patients were neurologically assessed. Pain scores decreased at 6 months postoperatively, compared to before surgery (P