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

John C. Clohisy, Behrooz A. Akbarnia, Richard D. Bucholz, J. Kenneth Burkus, Robert J. Backer

Research output: Contribution to journalArticle

90 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)325-330
Number of pages6
JournalSpine
Volume17
DOIs
StatePublished - Aug 1992

Keywords

  • Anterior decompression
  • Neurologic recovary
  • Spine fractures

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