Turkish Neurosurgery
Transpedicular Corpectomy and Anterior Column Reconstruction for the Treatment of Traumatic Thoracolumbar Fractures
Mehmet Yigit Akgun1, Mustafa Onur Ulu2, Orkhan Alizada3, Mahmut Ozden4, Murat Hanci2
1Koc University Hospital, Neurosurgery, Istanbul,
2Istanbul University-Cerrahpasa, Neurosurgery, Istanbul,
3Baskent University, Neurosurgery, Istanbul,
4Bahcelievler Memorial Hospital, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.40149-22.3

Aim:Burst fractures of the thoracolumbar spine can be treated with anterior, posterior-only, or combined approaches for the reconstruction of the anterior columns at the fracture level. However, the ideal surgical approach in this scenario remains debatable. We retrospectively analyzed the results obtained with the posterior-only approach in non-pathological traumatic thoracolumbar corpus fractures with spinal cord compression in this study.Material and Methods:A total of 17 patients with traumatic non-pathological thoracolumbar fractures were included in the study. Demographic details include preoperative data such as neurological status, deformity, pain scores, and radiology; intraoperative data such as blood loss, duration of surgery, and complications, and postoperative data including the neurologic status; the duration of hospital stay, pain scores, and deformity correction were analyzed.Results:Among the 17 patients, 8 were in ASIA A, 9 had incomplete neurologic deficits (ASIA C - D), and none was neurologically intact (ASIA E) preoperatively. All patients had TLICS scores >4 and were treated surgically. The mean TLICS score was 7.31. Although no worsening was detected in the neurological images of the patients during the postoperative period, neurological improvement of at least one ASIA grade was detected in 13 patients. However, it was found that the neurological functions remained the same in the 4 patients. With significant improvement, the mean preoperative VAS score was 8.2, while the mean postoperative VAS score was 3.3. In addition, satisfactory outcomes were obtained in radiological examinations, both in terms of kyphotic deformity and vertebral body collapse.Conclusion:Traumatic thoracolumbar fractures can be effectively fixed with the posterior-only approach and the transpedicular route. One of the most significant advantages of this procedure is that peripheral decompression, reduction, anterior column reconstruction, and instrumentation all can be performed simultaneously in the same session.

Corresponding author : Mehmet Yigit Akgun