Surgical Management of Thoracolumbar Spine Fractures with Incomplete Neurologic Deficits

The results of surgical decompression (SD) in 59 patients with neurologic deficits secondary to thoracic or lumbar fractures were evaluated at a mean of 3.7 years after injury. The purpose was to determine whether SD could be correlated with subsequent neurologic outcome. Follow-up neurologic evaluations showed a greater neurologic improvement in the 20 patients who were treated with anterior spinal SD as compared to the 39 patients who received posterior or lateral SD (88% vs. 64%). The return of normal bowel and bladder control also occurred more frequently in the anteriorly SD group than the posteriorly treated SD group (69% vs. 33%). The inferior results in the posteriorly treated SD group appeared to correlate with a high incidence of bony stenosis as measured on postoperative computed axial tomography.