[Three-column reconstruction via posterior approach for the treatment of unstable thoracolumbar fracture accompanied by posterior column injury].

Objective: To investigate clinical effects of three-column reconstruction via single posterior approach for the treatment of unstable thoracolumbar fractures accompanied by posterior column injury.

Methods: From December 2008 to May 2010,three-column reconstruction via posterior approach was implemented to 21 patients with unstable thoracolumbar fractures accompanied by posterior column injuries. There were 13 males and 8 females, ranging in age from 23 to 54 years old(averaged,35.5 years old). Injured vertebrae: 1 patient had injury in T11, 4 patients had injuries in T12, 8 patients had injuries in L1, 5 patients had injuries in L2, 3 patients had injuries in L3. The Cobb angle was (25.34 +/- 3.42) degrees. The operation time,blood loss during operation, Cobb angle and the bony fusion were observed.

Results: Twenty-one patients were followed up, and the duration ranged from 24 to 27 years old, with an average of 25.6 months. The operation time ranged from 135 to 275 min, with a mean of 185 min. The blood loss during operation ranged from 700 to 1 650 ml (averaged, 870 ml). All the patients had complete decompression. Postoperative Cobb angle was (4.01 +/- 2.03) degrees, and (4.34 +/- 2.38) degrees at the latest follow-up. All the patients got bony fusion.

Conclusion: To the patients with unstable thoracolumbar fractures accompanied by posterior column injuries, three-column reconstruction via single posterior approach has both anterior approach and posterior approach advantages, which can obtain excellent clinical outcomes.