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October2014 Vol.51 Issue:        4        Table of Contents
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Surgical Anterolateral Decompression of Type A3 Thoracolumbar Fractures and Fixation using Vantage Anterior Plate System: A Report of Six Cases

Mohamed Awad M. Ismail1,2

Department of Neurosurgery1, Ain Shams University; Saudi German Hospital2; KSA



ABSTRACT

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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