The Feasibility of the Posterior Approach as a Surgical Technique for the Management of Severe Thoracolumbar Fracture Dislocation
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- Category: Vol. 91, September 2023
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The Feasibility of the Posterior Approach as a Surgical Technique for the Management of Severe Thoracolumbar Fracture Dislocation, MOSTAFA F. TANTAWY, AHMED KOHEIL and AHMED ATALLAH SAAD
Abstract
Background: Vertebral fracture dislocation results from failure of the three columns under compression, rotation, and tension. This failure is the main differentiating feature of these types of spinal fractures. Most of these fractures result in severe spinal cord injury and complete neurological impairment. Aim of Study: The purpose of this study is to report our short-term experience with the posterior surgical approach to managing severe traumatic thoracolumbar fracture dislocation. Patients and Methods: This retrospective study involved the enrollment of 25 patients who received single-stage posterior surgery for fracture dislocation of the thoracolumbar spine between January 2019 and January 2021. A comprehen-sive review was conducted on demographic data, medical records, and radiographic images retrieved from the PACS workstation, which stands for picture archiving and commu-nication system. Results: Twelve patients were found to have a thoraco-lumbar fracture, with 10 of them located in the thoracic region and 3 in the lumbar region. Fifteen patients had an ASIA grade of A, three patients had an ASIA grade of B, three patients had an ASIA grade of C, two patients had an ASIA grade of D, and two patients had an ASIA grade of E prior to surgery. Fifteen patients had an ASIA grade of A, two patients had an ASIA grade of C, three patients had an ASIA grade of D, and five patients had an ASIA grade of E postoperatively. The patients' mean age was 34.76. The mean duration of hospital stay was 4.52 days. The mean duration of the surgical procedure was 235.20 minutes. The average preoperative kyphosis was 14.28, while the average postoperative kyphosis was –0.980. A significant statistical difference was observed between the preoperative and postoperative kyphosis, as indicated by a p-value of less than 0.05. A significant statistical difference was observed in the neurological improvement of patients with incomplete and complete spinal cord injuries, as indicated by a p-value of less than 0.05. Conclusion: According to our research, the utilization of the posterior surgical technique is both safe and effective in treating severe traumatic thoracolumbar dislocation. The intervention resulted in substantial improvements in the sagittal plane and overall quality of life.