학술논문
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Evaluation and Treatment of Patients with Thoracolumbar Spine Trauma: Surgical Approaches
THORACOLUMBAR TRAUMA GUIDELINES
THORACOLUMBAR TRAUMA GUIDELINES
Document Type
Report
Author
Source
Neurosurgery. January 2019, Vol. 84 Issue 1, pE56, 3 p.
Subject
Language
English
ISSN
0148-396X
Abstract
Goals and Rationale The surgical management of thoracolumbar fractures is highly variable. The objectives of surgical treatment of thoracolumbar fractures are to decompress neural elements when required, realign the spine, [...]
QUESTION: Does the choice of surgical approach (anterior, posterior, or combined anterior-posterior) improve clinical outcomes in patients with thoracic and lumbar fractures? RECOMMENDATIONS: In the surgical treatment of patients with thoracolumbar burst fractures, physicians may use an anterior, posterior, or a combined approach as the selection of approach does not appear to impact clinical or neurological outcomes. Strength of Recommendation: Grade B With regard to radiologic outcomes in the surgical treatment of patients with thoracolumbar fractures, physicians may utilize an anterior, posterior, or combined approach because there is conflicting evidence in the comparison among approaches. Strength of Recommendation: Grade Insufficient With regard to complications in the surgical treatment of patients with thoracolumbar fractures, physicians may use an anterior, posterior, or combined approach because there is conflicting evidence in the comparison among approaches. Strength of Recommendation: Grade Insufficient The full version of the guideline can be reviewed at: https://www.cns.org/guidelinechapters/congress-neurological- surgeons-systematic-review-evidence-based-guidelines/ chapter_11. KEY WORDS: Anterior decompression and fusion, Combined anterior and posterior approach, Posterior instrumentation, Surgical approach, Surgical treatment, Thoracolumbar fractures
QUESTION: Does the choice of surgical approach (anterior, posterior, or combined anterior-posterior) improve clinical outcomes in patients with thoracic and lumbar fractures? RECOMMENDATIONS: In the surgical treatment of patients with thoracolumbar burst fractures, physicians may use an anterior, posterior, or a combined approach as the selection of approach does not appear to impact clinical or neurological outcomes. Strength of Recommendation: Grade B With regard to radiologic outcomes in the surgical treatment of patients with thoracolumbar fractures, physicians may utilize an anterior, posterior, or combined approach because there is conflicting evidence in the comparison among approaches. Strength of Recommendation: Grade Insufficient With regard to complications in the surgical treatment of patients with thoracolumbar fractures, physicians may use an anterior, posterior, or combined approach because there is conflicting evidence in the comparison among approaches. Strength of Recommendation: Grade Insufficient The full version of the guideline can be reviewed at: https://www.cns.org/guidelinechapters/congress-neurological- surgeons-systematic-review-evidence-based-guidelines/ chapter_11. KEY WORDS: Anterior decompression and fusion, Combined anterior and posterior approach, Posterior instrumentation, Surgical approach, Surgical treatment, Thoracolumbar fractures