TITLE:
Anterolateral Approach for Unstable Lumbar Burst Fracture with Anterior Compression
AUTHORS:
Wael A. Hammad, Mohamed A. Barania, Islam M. Alaghory, Ahmed M. El Sherif
KEYWORDS:
Burst Fracture
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.8 No.2,
April
12,
2018
ABSTRACT:
Background: Lumbar burst fractures are common spinal injuries that cause severe
instability with kyphotic deformities and neurological complications requiring surgical
decompression and reconstruction with spinal instrumentation for unstable burst
fracture, but there is controversy about the optimal surgical approach anterior, posterior or combined
approach. Objectives: To assess the efficacy & safety of anterolateral approach
in decompression and reconstruction with spinal instrumentation for lumbar
burst fractures. Subjects & Methods: A
retrospective study including 16 patients, 10 males and 6 females with lumbar burst fractures
and anterior compression treated operatively by anterolateral approach for
corpectomy and single level fusion by using expandable cage or mesh cage loaded
with bone graft and plat with screws. The clinical and radiological follow up
after discharge from the hospital ranged from 12 to 24 months. Results:
All patients improved regarding the Frankel score more than one grade after
surgery, except 2 cases of grade A didn’t improve. Mean preoperative visual analogue scale was 7.4
improving to 0.9 postoperatively. The mean Local kyphosis improved from 8.8° before surgery to -1° after surgery. Conclusions: Anterolateral approach
is feasible, effective, and safe approach for unstable lumbar burst fractures. Angular
deformity is successfully corrected when the anterior approach is used.