Single-Centre experience with independent anterior retroperitoneal decompression and reconstruction of burst lumbar fractures | ||
| Pan Arab Journal of Neurosurgery | ||
| Article 12, Volume 20, Issue 1, June 2025, Pages 87-94 PDF (1.31 M) | ||
| Document Type: Original Articles | ||
| DOI: 10.21608/pajn.2025.333618.1160 | ||
| Authors | ||
| Nehal Bassioni Shabaan1; Yasser Fouad Ghoraba* 2; Ebrahim Ahmed Shamhoot3 | ||
| 1Neurosurgery department, faculty of medicine, Tanta university | ||
| 2Neurosurgery department, Faculty of medicine, Tanta university. | ||
| 3Neurosurgery Department, Faculty of Medicine, Tanta University, Egypt | ||
| Abstract | ||
| Background: A common spinal injury that causes instability, kyphotic deformities, and intra-canal bone pieces that cause neurological troubles and necessitate surgical decompression and reconstruction is a lumbar burst fracture. The ideal surgical technique is still debatable. Purpose: This study was set to retrospectively assess our center's experience with surgical treatment for some kinds of unstable three-column thoracolumbar fractures, which is achieved via a single-stage, independent anterior surgery with anterior fixation. Methods: Twenty patients with traumatic lumbar burst fracture with anterior canal compromise were included between July 2021 and July 2023. All patients had surgical decompression and stabilization using a standalone anterior approach. Results: The L1 vertebra was the site of 40% of the fractures. A minimum of six months were spent monitoring every patient. patient had the thoracolumbar injury classification and severity score (TLICS score) with a mean of 7.4, and the Oswestry Disability Index (ODI) ranged from 80–90 before surgery and 21–50 after surgery. 75% of neurologically affected patients improved at least one grade according to the Frankel classification scale of neurological affection after surgery, except 3 cases with no improvement of the preoperative A-score. The kyphotic angle showed improvement from the mean angle 9.5˚ before surgery to the mean angle 2˚, 8˚ after surgery. Conclusion: The direct anterior decompression of neural elements with contemporary anterior spinal instrumentation and reconstruction improves segmental angulation without violation of the intact posterior column and has a shorter fusion segment compared to posterior fusion. It also has acceptable operation time and perioperative complications. | ||
| Keywords | ||
| Burst lumbar fractures; retroperitoneal decompression; anterior lumbar fixation | ||
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