The anterior approach for surgery in thoracolumbar injuries allows decompression of anterior neural compression, reconstruction of the anterior and middle columns of the thoracolumbar spine, and osteototomy through the vertebral body if there is a need for late correction of deformity. In acute injuries the burst fracture with neurological injury is the ideal indication for anterior surgery and reconstruction. Because of the neural anatomy in the spinal canal at the throracolumbar junction, the injury can involve cord, conus, nerve root and peripheral nerve in either a pure or mixed lesion, with variable prognosis for recovery. The decompression optimises neurological recovery on the basis of animal models and clinical series of late decompression cases. In the last few years there has been a dramatic increase in the reconstruction options that have improved post surgical spinal stability and reduced morbidity from major bone grafting techniques. Anterior vertebral plates, dual rod and screw systems, titanium mesh cages, and now expanding cages facilitate reconstruction and improve stability, however this procedure remains technically demanding with significant morbidity for the patient.
Ns10 anterior approaches for thoracolumbar fractures. Publishing Authors By Initials
