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Surgical Anterolateral Decompression of Type A3 Thoracolumbar Fractures and Fixation using Vantage Anterior Plate System: A Report of Six Cases
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Mohamed
Awad M. Ismail1,2
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Department of Neurosurgery1, Ain Shams University; Saudi German Hospital2;
KSA
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ABSTRACT
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Background: Thoracolumbar fractures (TLF) are common spine injuries, mostly of
traumatic origin. Treatment options include conservative, open surgery and
minimal invasive techniques; depending on the type of fracture, neurological
state, available equipment, and surgeon’s experience. Objective: to
evaluate the new Vantage anterior fixation plate system (Medtronic Sofamor
Danek - Memphis, USA) in treatment of these
fractures and evaluation of surgical technique feasibility and possible
complications. Methods: Over a 3-year period, 6 male patients with
unstable thoracolumbar burst admitted in neurosurgery department Saudi German
Hospital were treated
with anterolateral decompression and stabilization using Vantage system.
Inclusion criteria are; patients without neurologic or with partial neurologic
deficits, intact posterior column
structures (Type A3, AO classification), marked compromise of the neural
canal, average body built, young ages, no history of active or chronic lung
diseases, no previous renal surgery or ureteric injuries. Results: Mean
age at surgery was 38, and the mean interval between initial injury and vantage
plate instrumentation was 5 days. Mean follow up period was 18 months. There
were complete canal clearance and correction of deformity in all patients. All
patients showed neurologic recovery except one patient with persistent
incontinence. No major perioperative complications were encountered except one
case with intercostal nerve injury, which improved during follow-up. No hardware
related complications were encountered. Conclusion: Anterior approach to
the thoracolumbar spine is very effective in decompression and provide solid
fixation by the vantage system. A low profile user-friendly vantage system
makes anterior stabilization fixation is easy and safe. [Egypt
J Neurol Psychiat Neurosurg. 2014; 51(4): 413-419]
Key Words: thoracolumbar, anterolateral, thoracotomy,
retroperitoneal, fracture
Correspondence
to Mohamed Awad M. Ismail. Department of Neurosurgery, Ain Shams University,
Tel.:
+966564266618+966564266618 Email:futureawad@yahoo.com
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