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POSTEROLATERAL DECOMPRESSION FOR TREATMENT OF VERTEBRAL BURSTFRACTURES

  • Nikola AZAR
  • Cüneyt MİRZANLI
  • Mustafa CANİKLİOĞLU
  • H. R. GÜNGÖR
  • H. I. KUTLU

J Turk Spinal Surg 1993;4(2):36-39

Primary aim for treatment of vertebral burst fractures is to decompress, stabilise and fuse involved segments. Direct decompression may be accomplished either by anterior or posterior approaches. Posterolateral decom-pression, firstly described by Erickson in 1977, is a method vvhich allovvs both decompression and stabilisation in a single cession. Twenty-two patients (16 men. 6 women mean age 23 years) were treated in SSK İstanbul Hos-pital llnd Orthopaedics and Traumatology Clinic from October 1991 t o May 1994 by using posterolateral decompression, stabilisation, and fusion operations. Except of one patient ali the fractures were in thoracolumbar region, predominantly at first lumbar vertebrae (58 I percent). Narrovving of canal diameter 30 percent or more and or presence of neurologic deficit were the indications for decision of operation. Neurologic deficit was detected in eight patients (6 at Frankel C level and 2 at Frankel D level). Mean percentage of canal occlusion measured by use of computerised axiai tomography (CAT) was 43.4 percent. Ali the patients were evaluated both clinically and radiologically in May 1994. Mean follow-up period was 24.3 months (5 to 30 months). For clinical assessment of patients. Deniş Pain and Work scale and for radiological evaluation percent of canal compromise local kyphosis angle, anterior body compression were used as parameters. Ali the patients with neurologic deficit shovved one or two Frankel level improvement at the latest follow-up. Mean percentage of canal compromise improvement was 28 percent. Complications were postoperative exitus for one patient, and deep wound infection for another patient. As a result we concluded that in vertebral fractures with neurological deficit posterolateral decompression is an alternative to anterior route. For neurologically intact patients effects of direct and indirect decompression methods should be kept in mind in the light of recently published articles about remodelation process.

Keywords: Burst Fractures, posterolateral decompression.