What is the best treatment surgical treatment for thoracolumbar fracture-dislocation?

An article published in Spine examines two-year follow-up for surgical treatment for thoracolumbar fracture-dislocation.

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The study examines 61 patients with acute fracture-dislocation of the thoracolumbar joint from March 2010 to December 2011. The patients were assigned to a combined postanterior fusion and transforaminal thoracic interbody fusion. Twenty-seven patients underwent TTIF and 30 underwent posteroanterior fusion.

 

There were 57 patients who completed the two-year follow-up with 27 patients who underwent TTIF and 30 who underwent posteroanterior fusion. The researchers found both procedures had similar:

 

•    Fusion rate
•    Decompression extent
•    Loss of correction
•    Instrumentation failure rate
•    American Spinal Injury Association score
•    Visual Analogue Score
•    Oswestry Disability Index

 

But there was a difference in blood loss, operating time and perioperative complication rate; they were greater in the posteraoanterior fusion patients than the TTIF group.

 

“Our findings suggest that TTIF allows for safe interbody fusion and circumferential decompression requires only a posterior approach, and is associated with a lower incidence of surgery-related complications,” concluded the study authors.

 

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