Single midline posterior approach for 360 degree decompression and internal fixation with interbody bone graft fusion for severe thoracolumbar spinal fractures

Objective:To discuss the safety and effectiveness of the single midline posterior approach for 360° decompression and instrumented stabilization with interbody bone graft fusion for treatment severe thoracolumbar spinal fractures accompanied with spinal compression. Methods:From January 2009 to March 2010,5 consecutive cases with severe thoracolumbar spinal fracture of totally 108 spinal fracture cases underwent a single midline posterior approach surgery. There were2 males and 3 females,aged from 23 to 72 years old. Two cases had both T12and L1fractures,and 1 case had L1fracture. The length of the surgical procedure,estimated intra operative blood loss,VAS score and dosages of morphine at the first 24 hours after operation,the peri operative complications were recorded. Results:Five patients were follow up from 12 to 18 months with an average of 14.6 months. The operative time was 3.1 to 6.2 hours. The blood loss was 1 000 to 2 300 ml. VAS score at the first post operative 24 hours was 1 to 4. The dosage of morphine of the first post operative 24 hours was 28.8 to 30.8 mg. The preoperative Frankel / ASIA grade was grade B in 1 case,C in 2 cases,D in 1 case and E in 1 case,the post operative Frankel/ASIA grade was E in 4 cases and D in case. No serious peri operative complications were found. Conclusion:The single midline posterior approach is a safe and effective surgical approach for 360° decompression and instrumented stabilization with interbody bone graft fusion for severe thoracolumbar spinal fractures with less post operative pains and complications.