Combined posterior and delayed staged mini-open anterior short-segment fusion for thoracolumbar XXXX .

@entity1 @entity174 @entity1513 @entity51 @entity158
STUDY DESIGN: A prospective study. OBJECTIVES: To assess the outcome of @entity1 with a single thoracolumbar burst @entity174 treated with circumferential short-segment fusion consisting of posterior reduction, short-segment fusion, and delayed staged mini-open anterior short-segment fusion. SUMMARY OF BACKGROUND DATA: The surgical treatment of thoracolumbar @entity174 remains controversial. In attempting to combine the advantages of posterior procedures, including initial correction of @entity1513 and early decompression, and those of anterior procedures, including direct decompression and restoration of anterior column support, a combined posterior and delayed staged anterior procedure seems to be a reasonable choice. However, conventional combined procedures are invasive. METHODS: We prospectively selected 28 consecutive @entity1 with single thoracolumbar burst @entity174 for circumferential short-segment fusion consisting of posterior reduction, short-segment fusion, and delayed staged mini-open anterior short-segment fusion. The pedicle screw systems were removed after confirmation of posterior bony fusion to preserve as many motion segments as possible in those @entity1 who could be treated with circumferential monosegmental fusion. Radiographic and clinical assessment of 28 @entity1 who received this treatment was carried out. RESULTS: The mean loss of correction of @entity1513 between the time of the combined procedure and final follow-up was 3.7 degrees (range, 0 to 10.2 degrees). Bony fusion was eventually achieved in all @entity1 . There were 15 cases with monosegmental and 13 cases with bisegmental circumferential fusion. All 10 @entity1 with initial @entity51 improved by at least 1 Frankel grade: 3 improved by 1 grade, 5 improved by 2 grades, and 2 improved by 3 grades. In total, 27 @entity1 , who were P1 or P2 on the @entity158 scale, were considered to have obtained clinically satisfactory results. CONCLUSIONS: This combined procedure is less invasive than the conventional combined one, and finally achieves shorter stabilization, resulting in preservation of motion segments. It thus seems to be a reasonable treatment option for thoracolumbar @entity174 .
