Anterior Lateral Approach for Anterior Decompression, Corpectomy, and Fixation with Webb Morley Procedure for Dorsolumbar Spinal Fracture
DOI:
https://doi.org/10.36552/pjns.v28i1.953Keywords:
Webb-Morley procedure, Anterior lateral decompressionAbstract
Objective: Efficacy of anterolateral approach Webb Morley procedure in a low-income country.
Materials & Methods: A descriptive study was conducted at the Department of Neurosurgery, Liaquat University of Medical and Health Sciences, Jamshoro. Patients of any gender presented to us with dorsal or lumber injury, plus a presentation on X-ray / MRI as spinal fractures having bone fragments pressing the cord, especially from the anterior side were included in the study. The assessed tool was based on clinical findings of Frankel's grading.
Results: We had 64 patients, who had dorsal and lumber fractures and went through the procedure of Webb Morley 43 were male and 31 were female patients The male-to-female ratio was 2:1 and the mean age was 39±3 yrs. with a median age was 42.5yrs. Fall (n = 34, 53.12%) was the common cause, road traffic accidents were (n = 16, 25%), fall of heavy objects (n = 11, 17.18%), and assault (n = 03, 4.68%).
Conclusion: Based on the current study of our Centre the anterior lateral approach for lower dorsal and upper lumber level with decompression and fixation with Webb-Morley procedure is a safe and effective method.
References
Lukas R, Suchomel P, Sram J. Surgical treatment of
thoracolumbar spine fractures. Coluna/columna. 2006;5(2):84-9.
Pandey S, Khare A, Mishra PK, Maravi DS, Gaur S. Post-operative neurological outcomes in patients of dorsolumbar fractures with incomplete spinal cord injury. International Journal of Orthopaedics. 2020;6(3):680-3.
Dashti H, Lee HC, Karaikovic EE. Robert W. Gaines Jr Decision making in dorsolumbar fractures. Neurology India. 2005;53.
Khursheed N, Sarmast A, Ramzan A, Dar B. Dorso-Lumbar Burst Fractures Secondary to a Peculiar Tipper Truck Injury: A Report on Two Cases. Indian Journal of Neurotrauma. 2015;12(02):140-3.
Ahsan MK, Sakeb N, Zaman N, Jannat SN. Management of traumatic spinal column injury: A tertiary hospital experience. Bangabandhu Sheikh Mujib Medical University Journal. 2015;8(2):95-104.
Ramani PS, Singhania BK, Murthy G. Combined anterior and posterior decompression and short segment fixation for unstable burst fractures in the dorso lumbar region. Neurology India. 2002;50(3):272.
Ajay MB, Vijayakumar AV. Comparative study between conventional open spine pedicle screw fixation surgery minimally invasive percutaneous pedicle screw fixations in the management of thoracolumbar spine fracture in adult. Int J Orthop Sci. 2016;2(4):154-9.
Lakshmanan P, Jones A, Mehta J, Ahuja S, Davies PR, Howes JP. Recurrence of kyphosis and its functional implications after surgical stabilization of dorsolumbar unstable burst fractures. The Spine Journal. 2009;9(12):1003-9.
Pannu CD, Farooque K, Sharma V, Singal D. Minimally invasive spine surgeries for treatment of thoracolumbar fractures of spine: a systematic review. Journal of clinical orthopaedics and trauma. 2019;10:S147-55.
Hai Y, Chan L. Recent Advancements in Robot-Assisted Spinal Surgery in China and Future Perspective. In Technical Advances in Minimally Invasive Spine Surgery: Navigation, Robotics, Endoscopy, Augmented and Virtual Reality 2022 (pp. 303-310). Singapore: Springer Nature Singapore.
Ha KY, Kim EH, Kim YH, Jang HD, Park HY, Cho CH, Cho RK, Kim SI. Surgical outcomes for late neurological deficits after long segment instrumentation for degenerative adult spinal deformity. Journal of Neurosurgery: Spine. 2021;35(3):340-6.
Kamboh UA, Mehboob M, Ashraf M, Shahid S, Sultan KA, Raza MA, Hussain SS, Ashraf N. Early Experience with Percutaneous Transpedicular Screw Fixation for Thoracolumbar Fractures at a Tertiary Hospital in Pakistan. Pakistan Journal of Neurological Surgery. 2021;25(2):215-24.
Delgado-López PD, Rodríguez-Salazar A, Martín-Velasco V, Martín-Alonso J, Castilla-Díez JM, Galacho-Harriero A, Araús-Galdós E. Rationale and complications of the anterior-lateral extrapleural retroperitoneal approach for unstable thoracolumbar fractures: experience in 86 consecutive patients. Neurocirugía (English Edition). 2017;28(5):218-34.
Neeley OJ, Kafka B, El Tecle N, Shi C, El Ahmadieh TY, Sagoo NS, Davies M, Johnson Z, Caruso JP, Hoeft J, Stutzman SE. Percutaneous screw fixation versus open fusion for the treatment of traumatic thoracolumbar fractures: A retrospective case series of 185 Patients with a single-level spinal column injury. Journal of Clinical Neuroscience. 2022;101:47-51.
Shin SR, Lee SS, Kim JH, Jung JH, Lee SK, Lee GJ, Moon BJ, Lee JK. Thoracolumbar burst fractures in patients with neurological deficit: Anterior approach versus posterior percutaneous fixation with laminotomy. Journal of Clinical Neuroscience. 2020;75:11-8.
Le H, Barber J, Phan E, Hurley Jr RK, Javidan Y. Minimally invasive lateral corpectomy of the thoracolumbar spine: A case series of 20 patients. Global spine journal. 2022;12(1):29-36.
Baaj AA, Dakwar E, Le TV, Smith DA, Ramos E, Smith WD, Uribe JS. Complications of the mini-open anterolateral approach to the thoracolumbar spine. Journal of Clinical Neuroscience. 2012;19(9):1265-7.
Hundal RS, Brooks NP, Williams SK. Lateral corpectomy and reconstruction for thoracolumbar burst fractures with neurological injury. In Seminars in Spine Surgery 2021 Mar 1 (Vol. 33, No. 1, p. 100849). WB Saunders.
Wood KB, Li W, Lebl DS, Ploumis A. Management of thoracolumbar spine fractures. The Spine
Journal. 2014;14(1):145-64.
Al Mamun MB, Hasan M, Islam SS, Alam MN, ur Rahman MM. Evaluation of Short Segment Fixation of Dorsolumbar Vertebral Injury with Incomplete Spinal Cord Injury. The Journal of Bangladesh Orthopaedic Society (JBOS). 2019;34(2): 57-61.
Sanandia J, Kansal DN, Dabhi R, Patel H. A study of operative and non-operative management of dorsolumbar spine fracture (A study OF 40 cases). International Journal of Orthopaedics. 2020;6(3):628-32.
Rehman L, Hashim AS, Khan HA, Arain SH, Ali S, Sheikh HA. Anterior decompression and fixation with Webb-Morley procedure in dorsolumbar spinal injury. Journal of the College of Physicians and Surgeons Pakistan. 2013;23(5):330-3.
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