Thoracoscopic Anterior Reconstruction Combined with Posterior Pedicle Screw-Based Fixation in Management of Thoracolumbar Junction Fractures

Abstract

Background: Video-assisted thoracoscopic surgery is a minimally invasive procedure applied to the field of spine surgery since 1990s. Purpose: To explore the feasibility, safety, efficacy, and cosmetic results of thoracoscopy in management of thoracolumbar fractures. Methods: We used both the Thoracolumbar Injury Classification and Severity (TLICS) score and the Load Sharing Classification Score for selection of cases. Cases were operated on by a combined approach of posterior pedicle screw fixation and anterior thoracoscopic reconstruction and fusion with follow up of cases up to 12 months as regard clinical and radiological results. Results: Patients’ ages ranged from 22-56 years, including 8 males and 7 females. Falls were the most common cause and LV1 was the most common level. Two cases were reconstructed by a corpectomy cage, while the rest by tricortical iliac bone graft. All except two cases showed signs of fusion at 12 months, while all cases were cosmetically satisfied. Neither major complications nor death were reported. Conclusion: Video-assisted thoracoscopic reconstruction of thoracolumbar fractures is an effective, minimally invasive, relatively safe technique that needs further training to widen its applications.(2012ESJ008)

Keywords

• Thoracolumbar
• fracture
• posterior fixation
• anterior approach
• thoracoscopy