Results of Staged 360-Degree Spinal Fusion for Unstable Thoracolumbar Burst Fracture

Seo, Jin Ho; Kim, Hyun Woo; Lee, Chul Young; Ha, Ho Gyun; Jung, Chul Ku

Abstract

OBJECTIVE
The purpose of this study was to evaluate the results obtained in patients who underwent staged 360-degree fusion with posterior fusion following anterolateral fusion for unstable thoracolumbar burst fractures.
METHODS
The authors performed 360-degree fusion for thoracolumbar burst fractures in 21 patients between 2006 and 2010. We reviewed the medical records and follow-up data including pre- and postoperative neurological status, spinal canal compromise, segmental kyphotic angulations, complications, visual analogue scale (VAS) pain scores, and revision surgery rates.
RESULTS
The mean computed tomography-measured preoperative spinal canal compromise was 55.9+/-20.7%. The segmental kyphotic deformity measured 20.2+/-4.4degrees preoperatively and had been corrected to 4.5+/-2.8degrees postoperatively. The mean vertebral body height loss of 57.4+/-6.9% improved significantly to 1.2+/-0.7% at the final follow-up examination. The mean preoperative VAS pain score of 8.2+/-0.8 improved to 1.5+/-0.6 at discharge. There were no cases of vascular complication, neurological deterioration, or revision surgery.
CONCLUSION
Unstable burst fracture of thoracolumbar spine managed by staged posterior fusion and anterolateral interbody fusionis effective for kyphosis correction, significant canal decompression, pain reduction, maintaining stabilization and neurological improvement.