Anterior decompresion and instrumentation with the Antares device and titanic cage for the treatment of instable thoracolumbar burst fractures

English Keywords:Thoracolumbar vertebrae  Burst fractures  Anterior  Internal fixation

English Abstract:

  【Abstract】 　Objective：To discuss the efficacy and indication of anterior decompression and fixation for the treatment of instable thoracolumbar burst fractures.Method：Between January 2005 and June 2007，Fourty-three cases with fractures of the thoracolumbar spine were treated with Antares device.There were 28 males and 15 females，with the average age of 37.3 years.The fracture located at T12 in 9 cases，L1 in 22 cases，L2 in 6 cases，T12，L1 and L5 in 1 case，T12 and L1 in 2 cases，L1 and L2 in 3 cases.The fracture was evaluated by Denis classification：A in 21 cases，B in 18 cases，E in 4 cases.31 cases were associated with neurological injury，Frankel A in 4 cases，B in 5 cases，C in 8 cases，D in 13 cases.12 cases were treated by transthoracic approach，25 cases by extrapleural and retroperitoneal approach，6 cases by retroperitoneal approach.16 cases with monosegmental fixation，27 cases with bisegmental fixation. Antares device was used for all cases.All patients were followed-up and their clinical outcomes were determined.Result：All operations were successfully completed.The average time with monosegmental fusion was 150±70min，the average blood loss was 428±85ml.The average time with bisegmental fusion was 260±78 hours，and average blood loss was 830±126ml. the thoracic cavity drainage time was 3.1d，ranged from 3 to 5d.The wounds obtained primary intention healing，but 3 cases were complicated with pulmonary infection，which cured by using antibiotics，the average postoperative kyphotic angle in monosegmental was 5.2°±3.3°（2.1°-10.4°），with an average corrective rate of（63.9±1.4）%.The average postoperation kyphotic angle in bisegmental was 4.9°±2.0°（2.5°-11.2°），with an average corrective rate of （66.2±2.2）%.During the follow-up，neither internal fixations failure，nor loss of the correction were observed and all fusions were successful.Postoperative neurological fuctions were improved above 1 grade at the last follow-up.Conclusion：Anterior decompression and fixation with Antares spinal systems provides a simple and effective technique for the surgical treatment of instable thoracolumbar burst fractures，which demonstrates the evidences of a through decompression，stable fixation and easy handling as well by this method.