The optimal management of thoracolumbar fractures, with respect to safety, fusion, and clinical outcomes remains uncertain and requires more comprehensive analysis of long-term outcomes. Schnake et al. report their prospective results of circumferential stabilization (posterior stabilization followed by corpectomy and expandable titanium cage placement) for type A.3, B, or C fractures at the T4 to L5 levels. Of 80 patients, 45 were followed for 5 years (56% follow-up). CT-confirmed bony fusion was achieved in 91% during followup despite noted subsidence and loss of correction (mean 2.6°). The peri-operative posterior and anterior approach-related overall complications were 13% and 37.5%, respectively (with most graded as minor and without cage-related complications). While mean Oswestry Disability Index scores were 12, 31% reported anterior-approach related paresthesias or pain at 5 years. Despite a relatively low follow-up rate (56%), circumferential stabilization was deemed safe with satisfactory clinical and radiographic outcomes.
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