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Anterior Z-plate and titanic mesh fixation for acute burst thoracolumbar fracture

STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate the clinical outcome, effectiveness, and security of the surgical management of acute thoracolumbar burst fracture with corpectomy, titanic mesh autograft, and Z-plate fixation by anterior approach. SUMMARY OF BACKGROUND DATA: Many surgical methods were adopted to treat acute burst thoracolumbar fracture. But the optimal surgical management remains controversial. METHODS: A retrospective review of a consecutive series of 48 patients with thoracolumbar burst fracture treated with anterior corpectomy, titanic mesh autograft, and Z-plate internal fixation was carried out. Preoperative clinical and radiographic data of all cases were originally collected. Surgical indications were motor neurologic deficit and thoracolumbar column instability. Twenty-two patients (45.8%) with acute thoracolumbar burst fractures presented with a neurologic deficit. The postoperative recovery of neural function, restoration of anterior cortex collapse, kyphotic angle, and spinal canal compromise were observed. RESULTS: The preoperative kyphotic angle was improved to a mean of 5.6 degrees , radiographic height restored to 95.8% of the adjacent normal levels, and canal compromise was 0%. None of the patients had neurologic deterioration. Mean follow-up time was 32.4 months (range, 24-47 months). All 22 patients with neurologic deficit demonstrated at least one Frankel grade improvement on final observation, with 16 (73%) patients had accomplished complete neurologic recovery. Forty-six (96%) patients reported minimal or no pain at final follow-up observation, and 40 (83%) patients who had been working before injury returned to original work. CONCLUSION: The authors considered spinal cord decompression with anterior corpectomy and stability reconstruction with titanic mesh autograft and Z-plate fixation at same time in one incision as an effective technique for unstable thoracolumbar burst fracture with and without neurologic deficit

Keywords : Acute Disease,Adult,China,diagnostic imaging,Female,Fracture Fixation,Internal,Humans,injuries,instrumentation,Internal Fixators,Lumbar Vertebrae,Male,methods,Middle Aged,Orthopedics,Pain,Patients,Radiography,Retrospective Studies,Spinal Canal,Spinal Cord,Spinal Fractures,surgery,Thoracic Vertebrae,Time,Titanium,Universities,Young Adult,, Zplate,Titanic,Mesh,Fixation, back pain centre london

Date of Publication : 2011 Apr 1

Authors : Xu JG;Zeng BF;Zhou W;Kong WQ;Fu YS;Zhao BZ;Zhang T;Lian XF;

Organisation : Department of Orthopedics, Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai, China. [email protected]

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21245791

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Anterior Z-plate and titanic mesh fixation for acute burst thoracolumbar fracture | Pain specialist

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