Anterior decompression and reconstruction with internal fixation for severe thoracolumbar burst fracture]

To explore the injury mechanism of the severe thoracolumbar burst fracture and the necessity of anterior decompression and reconstruction with internal fixation.From January 1999 to January 2004, 21 patients were treated with anterior decompression and reconstruction. The fractures were located at T12 in 6 patients, L1 in 12, L2 in 4, L3 in 3,and L4 in 1. Four patients were treated with the "anterior approach" and "posterior approach" surgeries for severe column fractures.All the patients were restored to the normal physiological radian, and the spinal canal was decompressed completely. They were followed up for 1-6 years, and the bony fusion was observed radiologically. The spinal cord function was improved to the 1-3 Frankel grade in all the patients except 2. There were no such complications as leakage of the cerebrospinal fluid, plate-screw loosening or breaking, or segment instability. The clinical effects were satisfactory.The operation of the anterior decompression and reconstruction with internal fixation for severe thoracolumbar burst fracture has advantages of complete decompression, full bone-grafting, and firm internal fixation. It can restore the spinal height and improve the spinal cord function.