Abstract
A combined posterior-anterior approach is usually proposed for the fixation of highly unstable spinal lesions. A monocortical anterior fixation seems to become more and more popular. In the period from 1993 to 1998, 43 patients with minimally anterior and middle column destruction of thoracolumbar spine were anteriorly instrumented. There were 23 tumors, 11 specific infections, 5 posttraumatic conditions with failed posterior instrumentation, 4 acute fractures. Anterior instrumentation (45Nm rod-screw rotation rigidity) were used in all cases. A four screws principle with two non connected rods were bicortically applied to correct the deformity and to fix the corpectomy gap. No postoperative bracing was necessary. There was one pseudarthrosis 2yrs post op. due to poor anterior fusion in a posttraumatic case. In one case instrumentation failure occurred due to widespreading of the prostatic tumor. The study revealed no complications due to bicortical screw fixation in thora-columbar region. It is suggested that combined anterior and posterior procedure is only exceptionally necessary.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
