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Journal of Korean Neurosurgical Society 2002;32(2): 112-117. |
One Stage Decompression and Circumferential Stabilization by Posterior Approach in the Unstable Burst Fracture of Thoracolumbar and Lumbar Spine . |
Kyung Hoon Hahn, Sang Gu Lee, Ju Ho Jeong, Chan Jong Yoo, Woo Kyung Kim, Young Bo Kim |
Department of Neurosurgery, Gachon Medical School, Gil Medical Center, Incheon, Korea. |
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ABSTRACT |
OBJECTIVE It has been known that the posterior pedicle screw fixation provides good mechanical stability in unstable burst fracture. But, posterior fixation without anterior column support may not be adequate to withstand the axial load and to keep the corrected kyphotic angle. We present results of one stage fixation by posterior approach in unstable burst fracture. METHODS Nine patients with unstable burst fracture were treated with posterior fixation and intervertebral fusion using titanium mesh cages and pedicle screws. The canal decompression was achieved by laminectomy and partial pediculectomy through the posterior approach. In all cases, the short segment fixation and anterior column support with cage were performed on the one stage operation. RESULTS Of nine patients, seven was satisfied with excellent clinical results except two cases of the Frankel's grade A. All patients had good stabilization of spinal column and enough decompression without any neurological complications. It was possible to maintain the corrected kyphotic angle with the circumferential stabilization(three column fixation). CONCLUSION The anterior and posterior column fixation through the posterior approach provides good stability and decompression in the patients with unstable burst fracture. |
Key Words:
Unstable burst fracture; One stage fixation; Circumferential stabilization; Posterior approach |
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