| ABSTRACT Objective：To explore a methods to decrease the post-operative spinal lateral angulation in surgery via anterior approach for lumbar fractures prospectively by way of incision modified. Methods: Comparative analysis of lateral angulation in 40 patients treated with surgery via anterior approach in thoracolumbar fractures between Jan 2016 to Jun 2017. These cases included 28 males and 12 females at the age o27-68 years(mean 39.5±14.9 years). The causes of injury were falling in 28 patients, impact from heavy material in 9 and traffic accidents in 3. 35 fractures was located at L1, 4 at L2, 1 at L3. The injury types all were A based on AO classification. According to Frankel assessment for neurological status, 25 cases were at grade A, 1 cases at B, 10 cases at C, 15 cases at D, 9 cases at E. Anterior fixation was performed with the ANTERIOR(Medtronic, Sofamor Danek). According to the random number table, it can be divided into two groups: modified incision groups and routine incision groups. Radiograph images were evaluated for coronal Cobb angle preoperatively and postoperatively and inserting angle between the screws and end-plates. Results: The postoperative coronal Cobb angle is 2.16±3.55° in modified incision groups and 3.91±3.78° in routine incision groups respectively. There is statistical difference in two groups（P=0.017）.There were 6 cases have above 5 degrees lateral angulation only in routine incision groups, however, no one in modified incision groups. There were statistical difference in two groups about the two inserting angle between the cephalic two screws and opposite end-plates. Conclusion: Incision modified could effectively prevent the post-operative spinal lateral angulation in surgery via anterior approach for lumbar fractures. |
