J Korean Neurosurg Soc.  2002 Aug;32(2):112-117.

One Stage Decompression and Circumferential Stabilization by Posterior Approach in the Unstable Burst Fracture of Thoracolumbar and Lumbar Spine

• Hahn KH
• Lee SG
• Jeong JH
• Yoo CJ
• Kim WK
• Kim YB

Abstract

OBJECTIVE
It has been known that the posterior pedicle screw fixation provides good mechanical stability in unstable burst fracture. But, posterior fixation without anterior column support may not be adequate to withstand the axial load and to keep the corrected kyphotic angle. We present results of one stage fixation by posterior approach in unstable burst fracture.
METHODS
Nine patients with unstable burst fracture were treated with posterior fixation and intervertebral fusion using titanium mesh cages and pedicle screws. The canal decompression was achieved by laminectomy and partial pediculectomy through the posterior approach. In all cases, the short segment fixation and anterior column support with cage were performed on the one stage operation.
RESULTS
Of nine patients, seven was satisfied with excellent clinical results except two cases of the Frankel's grade A. All patients had good stabilization of spinal column and enough decompression without any neurological complications. It was possible to maintain the corrected kyphotic angle with the circumferential stabilization(three column fixation).
CONCLUSION
The anterior and posterior column fixation through the posterior approach provides good stability and decompression in the patients with unstable burst fracture.

Keyword

Unstable burst fracture; One stage fixation; Circumferential stabilization; Posterior approach

MeSH Terms

Decompression*
Humans
Laminectomy
Spine*
Titanium
Titanium