Neurologic recovery associated with:Anterior decompression of spine fractures at the thoracolumbar junction (t12-l1)

Between "9B1 and 1USO, iwenty-lwo pationls with incomplete neurologic deficits after thoracolumbar junction fractures were treated by anterior decompression and stabilization. Two patients were unavailable for follow-up examination, eleven underwent spinal canal decompression within 48 hours of injury (Group A); and nine patients underwent surgical decompression In an average of 61 days after injury (Group SI, Neurologic recovery was analyzeo by a modified Franke) grading system, the ASIA motor point scale and tonus medullaris function. Patients were followed for an average of 3, 5 years (range, 6-92 months). No patients had any deterioration in neurologic function after surgery. Patients Group A hod a modified Frankel grado improvement with a median of two grades and a mean American Spine Injury Association motor point improvomonl of 21.1 -*¦ 4.1, Four of nine patients with conus medullars deficits demonstrated complete functional bladder and bowel return postoperatively. Those patients in Group B had a modified Frankel grade improvement with a median of one grade and a mean ASIA motor point improvement of 7, 6 n 1.7. Nona of the six patients with eonus medullar^ injuries showed complete improvement in biadder dt bowel function postoperatively. The modified Frankol grade and ASIA motor point score improvements were significant when the two groups were compared (P < 0, 04 and P< 0, 01, respectively]. In this series of patients, early anterior decompression for traumatic injuries at the thoracolumbar junction was associated with improved rates of neurologic recovery when compared to late decompression.