Surgical treatment of lower lumbar fracture with mini-incision via retroperitoneal anterior ap-proach

林建聪(Lin Jiancong，Dept Orthop，Zhangzhou Municip Affil Hosp Fujian Med Univ，Zhangzhou 363000)…∥Chin J Orthop.－2010，31(1).－ 50～54

Surgical treatment of lower lumbar fracture with mini-incision via retroperitoneal anterior ap-proach

林建聪(Lin Jiancong，Dept Orthop，Zhangzhou Municip Affil Hosp Fujian Med Univ，Zhangzhou 363000)…∥Chin J Orthop.－2010，31(1).－ 50～54

ObjectiveTo investigate the clinical effects of surgical treatment of lower lumbar fracture with mini-incision via retroperitoneal anterior approach.MethodsThe data of 21 cases with serious lower lumbar burst fracture were analyzed retrospectively.There were 15 males and 6 females with an average age of 35.9 years(ranged，19 －65 years).The lesion was located in L3 in 10 cases，L4 in 8 and L5 in 3cases.According to Magerl classification，there was type A(burst in 12 cases，type B(distraction)in 2 and type C(retortion)in 7 cases.All the 21 cases were treated with anterior decompression，bone graft fusion and internal fixation with mini-incision via retroperitoneal anterior approach.The changes of radiograph and neurologic status were recorded respectively.ResultsAll the cases had been followed up for an aver-age of 41.9 months(12 － 86 months).The radiograph showed obvious improvement on the injured body height(from 42.62%preoperatively to 94.33%postoperatively，P ＜ 0.01)and the canal encroachment index(from 2.67 preoperatively to 0.14 postoperatively，P ＜0.01).Significant improvement in neurological function were achieved in all patients with the improvement of one grade except for 1 case with L3，T11 fracture and complete paraplegia.No failure of implants was found during the follow-up period.ConclusionAnterior decompression and internal fixation with mini-incision via retroperitoneal anterior approach are successful in treating serious lower lumbar burst fractures.16 refs，5 figs，2 tabs.

(Authors)