ANTERIOR DECOMPRESSION FOR LATE PAIN AND PARALYSIS AFTER FRACTURES OFTHE THORACOLUMBAR SPINE

Anterior decompression of the thoracic and lumbar spine is indicated f or patients with trauma, infection, or tumor that causes compression o f the neural tissues, resulting in an incomplete neurologic deficit. T he complication of chronic pain, with or without paralysis, that resul ts from fractures with canal compromise has received little attention. This study involved 45 patients who had anterior decompression for ch ronic pain or paralysis at an average of 4.5 years after having thorac olumbar fractures. Pain was improved in 11 of 45 patients, with comple te relief in 30 and partial relief in 11. In 25 patients with neurolog ic deficit, 21 noted improvement, 14 of which improved one or more gra des of the Eismont classification. No patient had an increase in pain or loss of neurologic function. Complications were few. Anterior decom pression of the thoracolumbar spine for chronic pain after thoracolumb ar fractures is a safe and effective treatment for patients with this uncommon and difficult problem.