Treatment of Thoracolumbar Burst Fractures through Transforaminal Approach in the Window of Transverse Process

XIANG Zhi-jun; LIU Xi

Abstract：Objective To investigate the feasibility and efficacy of of thoracolumbar burst fractures with fracture fragments in spinal canal through transforaminal approach in the window of transverse process. Methods A retrospective analysis was carried out for 85 cases of thoracolumbar burst fracture from September 2007 to March 2011,and there were fracture fragments which were more thanl 30% diameter of spinal canal ratio. According to the TLISS,the total score was 4 to 7,averaged 5. 4, and by Frankel grade,9 cases with type A,12 cases with type B,19 cases with type C,14 cases with type D,31 cases with type F. All patients were treated by decompression,posterolateral bone graft fusion,and internal fixation through transforaminal ap-proach in the window of transverse process. Results Operation were successfully completed,the operative time was from 90 to 130 min with an average of 110 min,and the amount of blood loss was from 150 to 340 mL with an average of 220 mL;postop-erative vertebral height recovered satisfactorily,angular deformity disappeared;postoperative Franke classification was improved by an average of 1 to 3,and there were A grade in 6 cases,B grade in 9 cases,C grade in16 cases,D grade in 13 cases,E grade in 4 1 cases;preoperative and postoperative vertebral wedge angle ,junctional kyphosis change had significant difference( P <0. 05). Conclusion The operation through transforaminal approach in the window of transverse process implemented easily, and it also has the advantages of both anterior and posterior operation in treatment of thoracolumbar burst fracture. It is an ideal new option that can fully decompress,effectively restore the volume of vertebral canal and spinal stability.