Anterior fixation for burst fractures of the thoracic and lumbar spine with or without neurological involvement.

This report details the use of the anterior approach for burst fractures of the thoracic and lumbar spine. The indication for dural decompression is acute neurological injury arising from significant canal intrusion. The use of anterior fixation devices, and in particular the anterior Kostuik-Harrington system, generally eliminates the necessity for a posterior approach. Anterior surgery has been performed in 80 cases for burst injuries of the thoracic and lumbar spine. Fifty-seven of these were paraparetic. While there were two cases of nonunion and 11 screw breakages, there were no early or late vascular or neurological complications. Average neurological recovery was 1.6 grades on the Frankel scale. All incomplete paraplegics recovered at least one grade. All complete paraplegics (four) failed to show any recovery.