일측성 후방접근법을 이요한 흉요추부 골절의 전후방 동시 척추고정술

Abstract

Objective : The purpose of this study is to report the technical feasibility and the result of one stage operation for the bursting fracture of the thoracolumbar spine by posterior approach. Methods : Seven patients underwent corpectomy and replaced the space with titanium mesh cage filled up with autologous bone pieces through unilateral posterior route after removal of the facet joint and the pedicle followed by pedicle screw fixation at the same surgical field. Results : All patients tolerated the procedures well except one patient complicated with air embolism. Postoperative radiographs showed effective decompression and well placed instruments. Preoperative neurological deficits disappeared completely in two patients but some deficits persisted in the remainders. In two patients, epidural venous bleeding was troublesome and he needed transfusion of 5 pints of packed red blood cell. And another patient complicated with air embolism during operation was recovered with impunity after operation. To insert the mesh cage through the narrow corridor posterolaterally, it was unavoidable to sacrifice one spinal root. Conclusion : In spite of technical difficulty, one stage spondylodesis for the bursting thoracolumbar spine though unilateral posterior approach seem to be an effective operative procedure.