Các bác sĩ phẫu thuật điều trị bệnh nhân cột sống Ai Must Be Có thể áp dụng một chấn thương giống các kỹ thuật quản lý để Đạt được chăm sóc tối ưu của bệnh nhân. Phương pháp phẫu thuật trước IS Thích hợp cho các gãy xương vỡ trong thoracolumbar Một số bệnh nhân bị thâm hụt | Thoracolumbar Fracture Management Anterior Approach John S. Kirkpatrick MD Abstract The surgeon who treats patients with spine trauma must be able to apply a variety of management techniques to achieve optimal care of the patient. The anterior surgical approach is appropriate for some thoracolumbar burst fractures in patients with neurologic de cit and without posterior ligamentous injury. Surgery is most often indicated for patients with incomplete de cit especially those with a large retro-pulsed fragment marked canal compromise severe anterior comminution or kyphosis 30 . This approach provides excellent visualization of the anterior aspect of the dura mater for decompression. Reconstruction of the anterior body defect can be done with autograft allograft ora cage. Supplementation of the graft with anterior internal xation helps prevent kyphosis. Clinical results demonstrate improved neurologic function in most patients as well as low pseudarthrosis rates. In patients with incomplete de cit improvement in neurologic function usually can be expected with few complications. J Am Acad Orthop Surg 2003 11 355-363 The goals of thoracolumbar fracture management are to preserve or restore the neurologic and biomechanical functions of the spine. Both non-surgical and surgical management have a role. Optimal surgical management of thoracolumbar fractures requires understanding the patient s clinical situation the fracture classi- cation and the strengths and weaknesses of a variety of approaches and stabilization techniques. The anterior approach can be used for both management of the neurologic de cit and restoration of stability to the spine. In most patients neurologic de cit is caused by impact and or compression to the ventral surface of the spinal cord. The anterior approach provides optimal direct exposure for visualization of the ventral aspect of the dura mater during surgical Additionally for fracture patterns involving marked comminution with .
