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Posterior direct decompression and fusion of the lower thoracic and lumbar fractures with neurological deficit

STUDY DESIGN: A retrospective study. PURPOSE: To analyze the treatment outcome of patients with lower thoracic and lumbar fractures combined with neurological deficits. OVERVIEW OF LITERATURE: Although various methods of the surgical treatment for lower thoracic and lumbar fractures are used, there has been no surgical treatment established as a superior option than others. METHODS: Between March 2001 and August 2009, this study enrolled 13 patients with lower thoracic and lumbar fractures who underwent spinal canal decompression by removing posteriorly displaced bony fragments via the posterior approach and who followed up for more than a year. We analyzed the difference between the preoperative and postoperative extents of canal encroachment, degrees of neurologic deficits and changes in the local kyphotic angle. RESULTS: The average age of the patients was 37 years. There were 10 patients with unstable burst factures and 3 patients with translational injuries. Canal encroachment improved from preoperative average of 84% to 9% postoperatively. Local kyphosis also improved from 20.5 degrees to 1.5 degrees . In 92% (12/13) of the patients, neurologic deficit improved more than Frankel grade 1 and an average improvement of 1.7 grade was observed. Deterioration of neurologic symptoms was not observed. Although some loss of reduction of kyphotic deformity was observed at the final follow-up, serious complications were not observed. CONCLUSIONS: When posteriorly displaced bony fragments were removed by the posterior approach, neurological recovery could be facilitated by adequate decompression without serious complications. The posterior direct decompression could be used as one of treatments for lower thoracic and lumbar fractures combined with neurologic injuries

Keywords : complications,Decompression,injuries,Kyphosis,methods,Patients,Retrospective Studies,Spinal Canal,surgery,Treatment Outcome,Universities,, Direct,Decompression,Fusion, epidural cost uk

Date of Publication : 2011 Sep

Authors : Jun DS;Yu CH;Ahn BG;

Organisation : Department of Orthopedic Surgery, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea

Journal of Publication : Asian Spine J

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21892386

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Olivia James
Olivia James
2021-06-23
L4/5 Lumbar decompression and dynamic stabilisation. After 4 years of pain and inability to walk far without sitting down to take pressure off my back and leg, Mr Mo Akmal carried out L4/5 decompression and dynamic stabilisation. The relief from the pain was immediate and I was able to walk up straight at last, pain free. The whole process was really easy and straightforward and I was able to leave the hospital the same day. The difference it has made to my life is amazing. Mr Akmal and his team were professional, friendly and kind at every stage. I have no hesitation in recommending their services.
David Marks
David Marks
2021-06-21
Fantastic medical care I was suffering severe pain in my left leg; diagnosed by my GP as nerve related but no painkillers were having any real effect. Armed with an MRI, I saw Mr Akmal who said immediately that he knew what the problem was an recommended a surgical intervention as a guided cortisone injection would only provide temporary respite. The surgery recommended was the insertion of a small piece of titanium between the two vertebrae that were compressing the nerves going into my leg. I was advised that there were risks, although Mr Akmal's experience was that these risk were minimal. Surgery was arranged for the following week. I visited the hospital the day before the date arranged for surgery to have a number of pre-admission tests and all were fine. I came back the following day at 08:00 and was shown to a glass pod and changed for surgery. A local anaesthetic and sedation were administered and I was unaware of anything until I woke up shortly after the procedure. Within three hours of surgery I was walking, albeit somewhat gingerly and my wife collected me by car at 18:15 that evening to take me home. The nursing staff were very caring and helpful. I had clear instructions of what I needed to do in the two weeks after discharge and then saw Mr Akmal and his colleague 15 days later who inspected the wound from the surgery and said that they were satisfied with how I was healing. I would also mention that I had a phone call at from either Mr Akmal or a colleague to check on how I was doing and inviting me to call if if I was worried about anything every day apart from one for the six days after surgery. More importantly, the relief from the extreme pain was instantaneous. I am walking with a better posture and have had minimal soreness from the procedure. Overall, I would say that my experience was exceptional. I felt well looked after by a team expert in the issue and have immediate and a significant improvement in the quality of my life. There is, as I was told there would be, some residual discomfort from the nerve, which I am sure was in trauma and from the relevant muscles but this improves every day
Martin Williams
Martin Williams
2021-06-03
change your life... I've just completed 3 months with Spine Central and set to continue. after using other Chiro's before I can't tell you how much of a level up this is. My overall health, posture and 'lack of back pain' have really opened me up to a better future. being a Dad of a young 3 year old, I can enjoy the time so much with my Boy. thank you Spine Central.
Lisa P
Lisa P
2021-06-01
Mo Akmal & his team at The Spine unit were absolutely fantastic! My mother walked into the hospital in terrible pain & walked out a few hours later pain free ! She is 87 and now feels like 67 ! The attention she got was excellent I would highly recommend!
Miles McWilliams
Miles McWilliams
2021-05-10
Dr Akmal and his team, I am so happy with A+++ I have known Dr Akmal and his team for the past 8 years, I have seen him and his team ON and OFF for issues regarding my neck, C4/5, C5/6 , C6/7. I first had 3 lots of injections into this area back at the start of things. This helped me for 3 years. Dr Akmal did not want to operate at the time due to my age still been under 40 then. After 3 years I had to see Dr Akmal and his team again. We tried the injection route again but after a few attempts we then had to make the call to cut. I had C5/6 and C6/7 +/- C4/5 anterior cervical decompression and fusion / disc replacement carried out. This was a success and I was out of the hospital within 3 days and recovery took place for the next few months. This year I was operated on the back of my neck for a posterior cervical foraminotomy on the left side at the C5/6 and C6/7 levels. We tried the injections last year but this did not help. Due to Covid to this should have been carried out last year. Dr Akmal explained the risks include nerve injury, dural tear and pain post-operatively but the procedure is fairly routine and the risks are relatively low. Surgery has now taken place back in February. I was released the same day later that evening and been back for my check ups and things are looking up. I am currently training for a half triathlon that I will take part in second week of July. I am doing anything from 120 km to 170 km a week on the bike and running now upto 10 km a day on my running days. I have not been able to swim yet due to pools been closed but I have no issues with movement in me neck. I am very happy I chose Dr Akmal from the start. I did seen two others before him, they were happy to just cut and not look at what was best for me. I also strongly believe the newer technology Dr Akmal uses has really helped me any my life style I lead with sports. I know I would not have had the same results if I did not take the route with Dr Akmal. I really can’t say much more but I am very happy I met Dr Akmal when I did, he has been great and so has his team. Patient Miles McWilliams 😊
Saima Kash
Saima Kash
2021-05-05
Highly recommended!! It was a fantastic experience for my mother in law right from the beginning when she had her first appt with Mr Akmal and was recommended to have a spinal surgery. He has been fantastic, extremely helpful and professional in helping her understand her own condition and pros and cons of the surgery and support her through out the whole process. I would highly recommend him for his excellent professional skills and experience in dealing with patients specially elderly patients.
Radu Ghebaru
Radu Ghebaru
2021-04-23
Professional services - spinal injections Quick and easy to book appointments (online and over the phone). Very helpful receptionist. I had a consultation with dr Akmal who is very professional , patient , kind and understanding. he explained me in details my problem. Trustful and confident in his job, I decided to follow his advice and treatment. I had yesterday a spinal injection . No sides effects so far. A bit in pain but it’s normal. I am aware that I will see the results in one week time only. Great team , exceptional staff (from the receptionist to the nurses and dr Akmal). I would recommend Harley Street Hospital - London Spine Unit to anyone who is having back pains.
Ashraf Elawad
Ashraf Elawad
2021-04-21
Lumbar Disc Surgery. I had difficult times with my disc prolapse in my lower back. The pain was getting worse despite pain killers and physiotherapy. I was a bit nervous considering surgical treatment as a definte solution. The consultation with Mr. Mo Akmal was informative and reassuring and helped me to make a decision going ahead for the surgical option. On the day of the procedure, the staff was welcoming and looked experienced and knew exaclty what they were doing. Mr. Mo Akmal spoke to me before and after the procedure. In less than 2hrs, after the porcedure, I was able to stand, walk, and sit down with no pain. I strongly recommend Mr. Mo Akmal for anybody who has a similar condition.
Joe massimo
Joe massimo
2021-04-16
L5/S1 Microdiscectomy Surgery for 21 year old with Mr Mo Akmal and London spine unit I had minimally invasive spinal surgery for a Bulging disc at L5/S1 impinging on my S1 nerve root. Before surgery I couldn’t walk without a limp and would be in too much pain to walk further than a mile. Being only 21 years old and a keen athlete and student Osteopath, with an interest in sports rehabilitation, I wanted to get back to complete health and fitness from this injury. There is definitely a fear with spinal surgery that a lot of people have in the sports and therapy world however I knew I needed the operation to gain my leg function back and with Mr Mo Akmal and the team at the London spine Unit, I felt in great hands and they were very professional from start to finish with the process. They made me feel very comfortable and safe. I’d highly recommend Mr Mo Akmal and the Team at the London Spine Unit, they are very friendly and take great care of you. I’m feeling much better and am glad I chose to get the surgery done here.
Noam
Noam
2021-04-14
Very good treatment Mr. Akmal Very good treatment from Mr. Akmal and the staff with amazing results. After the first spinal injection I was sure the treatment won't work but as the team encouraged me to keep going to the second injection it then total disappeared. They were also very helpful with all the documents needed for the insurance cover. Much appreciated! I was struggling

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Posterior direct decompression and fusion of the lower thoracic and lumbar fractures with neurological deficit | Hypermobility spectrum disorder treatment

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