The treatment of thoracolumbar vertebral fractures with anterior fusion and instrumentation

Objective: Retrospective assessment of functional and radiological efficiency of patients with thoracolumbar vertebral fractures and treated with anterior fusion and instrumentation in Cukurova University Orthopaedics and Traumatology Department.Materials and Methods: 38 patients, hospitalized with the diagnosis of thoracolumbar fracture, to Cukurova University Orthopaedics and Traumatology Department, between january 1995 and january 2010. Patients were assessed according to demographic status, the fracture level, characteristics of trauma, the time passed before the surgery and post-operative complications. Respectively pre-operative, ealy post-operative and late post-operative radiological measurement of local kyphosis angle, kyphotic deformity angle, anterior body height loss, narrowing of vertebral canal was determined. Patients were assessed with Frankel neurologic performance scale. At the end of the follow-up the functional evaluation was made with Oswestry disability index.Results: 20 of patients were male and 18 were female. The mean age was 33.9±15 years. the avarage follow-up was 36 ( 16-134) months. 68,4% of fractures according to fall from high, 26,3% motor-vehicle accident and 5,3% crushing injury. The frequency of fracture levels respectively were L1-L2 (57,8 %), T12 (14,8 %) and L3 (14,8%). 44,7% of patients had additional trauma. According to the radiologic evaluation, comparison of pre-operative and post-operative, there was a significant correction of local kyphosis, kyphotic deformity, anterior body height loss and canal narrowing was obtained (<0,001). At the end of follow up period there was statistically loss of correction was seen (<0,017). According to Frankel neurologic scale there was a progression at least one level. At the last follow-up period, the result of Oswestry disability index showed that 71,5% of patients had a perfect and 28,5% patients had a good result.Conclusion: Anterior fusion and instrumentation of thoracolumbar burst fractures is a efficient and reliable treatment modality to provide advantages such as, permission of direct decompression, short segment fusion application, structural support and the same complication ratio as posterior surgery.