Comparison of clinical effect and complications of anterior and posterior operative approach on thoracolumbar multiple level spinal fracture

YIN Yan-bin; LUAN Yan-jun

doi:10.3969/j.issn.1009-4237.2017.05.003

Abstract：Objective To explore the effectiveness of different operative approaches on thoracolumbar multiple level spinal fracture (MSF). Methods Data of 48 patients with thoracolumbar MSF in our hospital from Nov.2009 to Nov.2015 was retrospectively analysed.Twenty-eight cases recievced the posterior operative approach surgery and another 20 cases received anterior approach sugery.There was no significant difference between two groups in age,gender,complicated injury and the type of fracture.Indexes including the perioperative results,bone reduction,spinal nerve function and pain score were compared. Results The cases were followed up for 18 months on average.There were significant differences in bone reduction[(33.14±4.73) in posterior approach and (30.74±3.83) in anterior approach] and Cobb angle [(5.31±2.51) in posterior approach and (5.48±2.41) in anterior approach] when compared with before operation,but had no remarkable difference between two groups.There was no significant difference between two groups in spinal nerve function except for the motional function,with (67.31±2.51) in posterior approach and (78.48±2.41) in anterior approach.The anterior approach was worse than posterior in surgery time and perioperative bleeding but better in pain score. Conclusion Both operative approches are effective interventions for thoracolumbar MSF.There is no significant difference in bone reduction and spinal nerve function.But the anterior approach could do better in motional funtion.We beilive anterior appoarch is suitable in MSF with heavy nerve injury.