Anterior Versus Posterior Approach in the Treatment of Chronic Thoracolumbar Fractures

Full article available online at ORTHOSuperSite.com. Search: 20120123-05 The purpose of this study was to compare the results of anterior approach vs posterior approach in the treatment of chronic thoracolumbar fractures. A total of 36 patients with chronic thoracolumbar fractures were divided into 2 groups. Group A was treated by an anterior approach and group B was treated by a posterior approach. During the minimum 24-month follow-up period (range, 24-62 months), all patients were prospectively evaluated for clinical and radiologic outcomes. Intraoperative blood loss, operative time, operative complications, pulmonary function, Frankel scale, and American Spinal Injury Association (ASIA) motor score were used for clinical evaluation, and Cobb angle was examined for radiologic outcome. All patients in this study achieved solid fusion, with signifi cant neurologic improvement. Operative time, perioperative blood loss, ASIA score on admission and at fi nal follow-up, and complications of respiratory tract infection and intercostal nerve pain were not signifi cantly different between the 2 groups (P .05), but complications of hemopneumothorax, abdominal distension, and constipation were fewer in group B (P .05). Postoperative pulmonary function (P .05) and correction of posttraumatic kyphosis were better in group B (P .05). Drs Chen, Ding, Zhai, Lian, Kang, Guo, Liu, and Lin are from the Department of Orthopaedics, the 175th Hospital of PLA, Traumatic Orthopaedics Center of PLA, Southeast Hospital of Xiamen University, Zhangzhou, Fujian Province, PR China. Drs Chen, Ding, Zhai, Lian, Kang, Guo, Liu, and Lin have no relevant fi nancial relationships to disclose. Correspondence should be addressed to: Zhen-qi Ding, MD, Department of Orthopaedics, the 175th Hospital of PLA, Traumatic Orthopaedics Center of PLA, Southeast Hospital of Xiamen University, Zhanghua Rd, Zhangzhou, Fujian Province, PR China, 363000 (dzqi175@tom.com). doi: 10.3928/01477447-20120123-05 Anterior Versus Posterior Approach in the Treatment of Chronic Thoracolumbar Fractures ZHI-WEN CHEN, MD; ZHEN-QI DING, MD; WEN-LIANG ZHAI, MD; KE-JIAN LIAN, MD; LIANG-QI KANG, MD; LIN-XIN GUO, MD; HUI LIU, MD; BIN LIN, MD Figure: Lateral radiograph demonstrating a typical T12 chronic fracture. Note the kyphotic angulation.