脊椎ジャーナル

Thoracic and Lumbar Fractures: Mini-Open Anterior Fusion in 138 Patients

Abstract

Ersin Haciyakupoglu and Kristian Ebmeier

Background: Several surgical procedures have been recommended for the management of thoracic and lumbar fractures. Nowadays Mini- Open Anterior Fusion is reported to be a safe and effective alternative treatment for various spinal pathologies.
Aim: The aim of this study is to report the outcome of 138 cases who underwent mini open thoraco-lumbar surgery for thoracic and lumbar fractures.
Material and Methods: We performed a non-randomized retrospective analysis of the clinical outcome of 138 patients with 140 fractures who underwent mini open thoraco-lumbotomy surgery, between 2011 and 2016. Follow up periods were 6th weeks, 3rd and 6th months and also 1 year postoperatively. All the patients were operated with mini open thoraco/lumbotomy system (Syn-Frame). All of our patients with fractures, undervent posterior pedicle screw fixation prior to the anterior fusion just after the posterior fusion or a couple of days later (mean: 4.2; 2 to 7 days), depending on the general condition of patients. Thorax drainage was placed to all thoracotomy patients (63% to 87%).
Results: Fractures of 13 cases were due to tumor metastasis, and the rest of them were due to acute fractures, spondylodiscitis. 87 cases had thoracic (T6-T12) and 51 cases had lumbar (L1-L5) fractures. Discussion: Several methods are being used in order to achieve safe, and minimaly invasive approach in cases with thoracolumbar pathologies. The complication rates of this procedure are similar to endoscopy assisted thoracotomy. Syn-Frame System allows the opportunity to perform even 2-3 levels corpectomy and stabilization through a 5 cm skin incision. It is possible to insert 4 or more retractors from all angles to form an area just over the level operation level, without dealing with aorta, lung, urethra or heart.
Conclusion: We can estimate that this approach is safe, minimally invasive and effective besides reducing the pain and morbidity of conventional methods.