ANTERIOR INSTRUMENTATION IN THE MANAGEMENT OF THORACOLUMBAR BURST FRACTURES

Anterior instrumentation in the treatment of thoracolumbar fractures h as progressed significantly during the past 2 decades. These fixation systems have evolved to meet the anatomic, biomechanical, and imaging challenges associated with internal fixation of the thoracolumbar spin e. The evolution of these devices will be reviewed, and from this, the indications and surgical techniques necessary for the safe and effect ive use of the device will be discussed, This study also reports the a uthors' initial clinical experience using the Z plate anterior thoraco lumbar plating system in the treatment of thoracolumbar burst fracture s, The study consists of 12 consecutive adult patients who underwent a 1-stage anterolateral decompressive and stabilization procedure for b urst fractures from T9-L3, The indications for surgery included neurol ogic deficits, deformity, progressive kyphosis, and late pain, Ten of the 12 patients maintained their postoperative sagittal alignment or a significant portion of their kyphosis reduction, Two patients with se vere kyphotic deformities greater than 50 degrees lost 10 degrees and 20 degrees of their reduction at last followup, All 3 patients with ne urologic deficits recovered, There were no neurologic or perioperative complications. Eleven of the 12 patients obtained a good or excellent functional outcome. Anterior arthrodesis using instrumentation stabil ization after a 1-stage anterolateral decompression and reduction proc edure can yield successful clinical results in the treatment of thorac olumbar burst fractures.