ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Anterior versus posterior decompression for the treatment of thoracolumbar burst fracture- A single center prospective comparative study with short-term outcomes.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
STUDY
designA single-center prospective comparative analysis. Level II evidence.
objectiveTo compare the surgical and short-term clinical-radiological outcomes of anterior versus posterior decompression and stabilization for thoracolumbar burst fractures. MATERIALS AND
methodsThis single-center prospective comparative analysis included 43 consecutive patients with thoracolumbar burst fractures (AO type A3/A4) at the T10-L2 junction, TLICS ≥ 4, and neurological deficit. Twenty-eight patients underwent posterior decompression with pedicle-screw fixation (posterior group) and 15 underwent anterior decompression with anterior instrumentation (anterior group). Outcomes assessed included operative parameters, canal clearance on CT, kyphotic correction, neurological improvement (ASIA), and functional recovery (VAS, ODI, SCIM) over a six-month follow-up.
resultsThe posterior group had significantly shorter operative time and hospital stay (p < 0.05). Mean blood loss was comparable between groups (p = 0.10). Canal clearance was significantly greater in the anterior group (90.2%) than the posterior group (48.0%, p < 0.001). Mean kyphosis correction (posterior 12.7° ± 7.2 vs. anterior 9.9° ± 5.3, p = 0.10) and loss of correction at six months (posterior 6.3° ± 5.0 vs. anterior 2.0° ± 1.0, p = 0.07) were similar. Neurological and functional improvements were comparable (p > 0.05). Complications occurred in two posterior cases (infection, screw pull-out) and four anterior cases (two SPAM, two chest complications, one death).
conclusionBoth approaches provided effective decompression and stabilization. The anterior approach achieved superior canal clearance but required longer operative time and hospitalization, while posterior surgery offered shorter procedures with similar short-term neurological and functional outcomes. LEVEL II EVIDENCE: Study design: A single-center prospective comparative analysis.
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