The Efficiency and Reliability of Minimally Invasive Anterior Corpectomy and Percutaneous Posterior Stabilization for the Treatment of Unstable Thoracolumbar Burst Fractures

초록

-OBJECTIVE: The purpose of this study was to evaluate the radiological and clinical outcomes of minimally inva-sive anterior corpectomy and percutaneous posterior sta-bilization for treating unstable thoracolumbar burst fractures. -METHODS: Patients with unstable thoracolumbar burst fractures who underwent minimally invasive anterior cor-pectomy and percutaneous posterior stabilization between 2012 and 2019 at a tertiary hospital were enrolled. Radio-logical outcomes such as endplate subsidence and fusion status were identified on preoperative and postoperative plain radiographs and computed tomography images. Pre-operative and postoperative neurological statuses were evaluated using the American Spinal Injury Association impairment scale. Furthermore, operation-related parame-ters were analyzed. -RESULTS: In total, 21 patients (mean follow-up period, 21.7 months) were included in this study. Of them, 17 (80.95%) patients exhibited complete fusion according to the Bridwell's criteria at the final follow-up, and only 1 patient exhibited nonunion at the surgical level. Endplate subsidence was observed in 6 (28.57%) patients; however, there were no definite symptoms that would have neces-sitated a revision surgery. Of 15 patients with preoperative neurological impairment, 7 exhibited neurological improvement during follow-up. None of the patients expe-rienced postoperative neurological deterioration. Regarding operation-related parameters, the mean operative time and intraoperative blood loss were 266.19 +/- 51.54 min and 520.71 +/- 190.86 ml, respectively. The mean length of hospital stays and days to postoperative ambulation were 12.14 and 4.20 days, respectively. -CONCLUSIONS: Minimally invasive anterolateral cor-pectomy with percutaneous pedicle screw fixation is a reliable surgical treatment option for unstable thor-acolumbar burst fractures.

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