Simultaneous anterior and posterior approaches for correction of late deformity due to thoracolumbar fractures.

Thirty-one patients with an average age of 27 years were included in this study to analyze the short-term results of simultaneous anterior and posterior approaches in the treatment of late complications of thoracolumbar fractures. The complications treated were pseudoarthrosis and malunion resulting in neurologic compromise and pain. There were 20 burst fractures, 2 fracture/dislocations, and 9 compression fractures in this group. Average preoperative Sagittal Index was 35 degrees, which improved to an average of 4 degrees after surgical treatment. The average Motor Index Score improved from 90 to 98 after surgery. Average follow-up was 16 months. Average estimated blood loss was 2000 ml and average operation time was 5 h. It was concluded that the late problems associated with thoracolumbar fractures can be addressed quite adequately with simultaneous anterior and posterior approaches. The simultaneous anterior and posterior approach is associated with decreases in operating time, blood loss, and hospital stay. Technical advantages of the simultaneous technique include elimination of acute instability between the stages, protection against dislodgment of the graft, and application of the posterior instrumentation under complete visualization of the anterior graft.