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European Spine Journal

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01-05-2017 | Original Article

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

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

Published in: European Spine Journal | Issue 5/2017

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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Title: Modified one-stage posterior/anterior combined surgery with posterior pedicle instrumentation and anterior monosegmental reconstruction for unstable Denis type B thoracolumbar burst fracture
Authors: Oujie Lai
Yong Hu
Zhenshan Yuan
Xiaoyang Sun
Weixin Dong
Jiao Zhang
Binke Zhu
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 5/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4800-1

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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

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

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