Transforaminal lumbar interbody fusion for treatment of thoracolumbar burst fractures

Objective To evaluate the effects of transforaminal lumbar interbody fusion (TLIF) in the treatment of thoracolumbar burst fractures.Methods From January 2010 to January 2012,we performed TLIF for 23 patients with burst fracture of single thoracolumbar segment whose loss of anterior border height of the injured vertebra was over 50％ and over 40％ of whose spinal canal was occupied.They were 15 men and 8 women,22 to 61 years of age,averaging 45.3 years.The fractures happened at T12 in 5 cases,at L1 in 15 and at L2 in 3.By Denis classification,all of them were burst fracture.By the American Spinal Injury Association (ASIA) grading system,the neural function was rated as grade A in 1 cases,as grade B in 2,as grade C in 7,as grade D in 11 and as grade E in 2.Results The operation time ranged from 100 to 160 minutes,averaging 140 minutes; the bleeding volume ranged from 200 to 750 mL,averaging 370 mL.There were no inter-or post-operative complications.They were followed for 5 to 24 months,averaging 12.3 months.By the ASIA grading of their neural functional recovery at the last follow-up,one case was rated as grade A,1 cases as grade B,4 as grade C,7 as grade D and l0 as grade E,with an average improvement of 1.8 ASIA grades.The mean anterior border height of the injured vertebra recovered from 45.2％ ± 17.6％ of the normal height preoperation to 90.2％ ± 13.7％ postoperation; the mean posterior border height recovered from preoperative 81.5％ ± 14.3％ to postoperative 93.5％ ± 15.4％ ; the mean cobb angle decreased from preoperative 28.4° ± 11.8° to postoperative 6.4° ± 3.8°.The differences between preoperation and postoperation were significant (P ＜ 0.05).Conclusion In the treatment of thoracolumbar burst fractures,TLIF technique should be recommended because it can be used to complete decompression and internal fixation of the fracture and strut fusion of the anterior column simultaneously through a single posterior approach. Key words: Spinal cord injuries;  Fracture;  Spinal fusion