• Circumferential thoracolumbar fracture stabilization is safe, with high fusion and stabilization rates

    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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