[Anterior approach supporting bone graft for the treatment of old thoracolumbar fractures without neurological symptom].

OBJECTIVE: To retrospectively analyze the surgical effect of anterior approach bone graft and internal fixation methods for treating old thoracolumbar fracture without neurological symptom, so as to provide references for surgical treatment of such kind of fracture.

METHODS: From April 2004 to April 2009, 22 cases of old thoracolumbar fractures were treated, including 15 males and 7 females with an average age of 38 years ranging from 21 to 56 years. The time from injured to operation was from 4 months to 2 years (average 8 months). Anterior approach surporting bone graft and internal fixation were performed. All patients were followed up for at least 12 months, the Cobb angle depending on lateral radiographs and VAS scores were compared between pre-operative and post-operative. Complication was observed.

RESULTS: The average preoperative Cobb angle of kyphosis was (15.0 +/- 2.4) degrees (8.0 degrees to 28.0 degrees), VAS score was 7.0 +/- 0.7. The average two weeks after operation was (3.0 +/- 1.6) degrees (-2.0 degrees to 9.0 degrees), VAS score was 1.0 +/- 0.6. The average Cobb angle at one year after operation was (3.5 +/- 1.4) degrees (0.0 degrees to 12.0 degrees), VAS score was 1.2 +/- 0.6. There were statistically significant differences in the above indexes between preoperation and two weeks after operation (P<0.05), while no statistically significant difference was found between 2 weeks and 1 year after operation (P>0.05). Bony fusion were achieved in 21 patients, nounion were occurred in 1 patient, but without correction loss.

CONCLUSION: According to Cobb angle of kyphosis, anterior approach surporting bone graft and internal fixation is a reasonable strategy to treat old thoracolumbar fracture without neurological symptom.