Reddy Mallepally Abhinandan, Marathe Nandan, Shrivastava Abhinav Kumar, Tandon Vikas, Chhabra Harvinder Singh
Department of Spine Services, 76434Indian Spinal Injuries Centre, Vasant kunj, Sector C, New Delhi, India.
Global Spine J. 2022 Sep;12(7):1503-1515. doi: 10.1177/2192568220984128. Epub 2021 Jan 25.
Retrospective observational.
This study aimed to document the safety and efficacy of lumbar corpectomy with reconstruction of anterior column through posterior-only approach in complete burst fractures.
In this retrospective study, we analyzed complete lumbar burst fractures treated with corpectomy through posterior only approach between 2014 and 2018. Clinical and intraoperative data including pre and post-operative neurology as per the ISNCSCI grade, VAS score, operative time, blood loss and radiological parameters, including pre and post-surgery kyphosis, height loss and canal compromise was assessed.
A total of 45 patients, with a mean age of 38.89 and a TLICS score 5 or more were analyzed. Preoperative VAS was 7-10. Mean operating time was 219.56 ± 30.15 minutes. Mean blood loss was 1280 ± 224.21 ml. 23 patients underwent short segment fixation and 22 underwent long segment fixation. There was no deterioration in post-operative neurological status in any patient. At follow-up, the VAS score was in the range of 1-3. The difference in preoperative kyphosis and immediate post-operative deformity correction, preoperative loss of height in vertebra and immediate post-operative correction in height were significant (p < 0.05).
The posterior-only approach is safe, efficient, and provides rigid posterior stabilization, 360° neural decompression, and anterior reconstruction without the need for the anterior approach and its possible approach-related morbidity. We achieved good results with an all posterior approach in 45 patients of lumbar burst fracture (LBF) which is the largest series of this nature.
回顾性观察研究。
本研究旨在记录单纯后路腰椎椎体次全切除并前路重建治疗完全爆裂骨折的安全性和有效性。
在这项回顾性研究中，我们分析了2014年至2018年期间采用单纯后路椎体次全切除治疗的完全性腰椎爆裂骨折。评估临床和术中数据，包括根据ISNCSCI分级的术前和术后神经功能、视觉模拟评分（VAS）、手术时间、失血量以及影像学参数，包括术前和术后后凸畸形、椎体高度丢失和椎管占位情况。
共分析了45例患者，平均年龄38.89岁，胸腰段损伤严重程度评分（TLICS）为5分或更高。术前VAS评分为7 - 10分。平均手术时间为219.56±30.15分钟。平均失血量为1280±224.21毫升。23例患者接受短节段固定，22例接受长节段固定。所有患者术后神经功能均未恶化。随访时，VAS评分在1 - 3分之间。术前后凸畸形与术后即刻畸形矫正、术前椎体高度丢失与术后即刻高度矫正之间的差异具有统计学意义（p < 0.05）。
单纯后路手术安全、有效，可提供坚强的后路固定、360°神经减压和前路重建，无需前路手术及其可能的与手术入路相关的并发症。我们采用全后路手术治疗45例腰椎爆裂骨折患者取得了良好效果，这是此类规模最大的系列研究。
