Systematic Review Of Anterior Versus Posterior Surgical Treatments Of Thoracolumbar Fractures

Objective: To evaluate the effectiveness of anterior versus posterior surgical treatments of thoracolumbar fractures. Methods: Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were identified from MEDLINE (1966-2006.7) , EMBASE (1966-2006.7), PubMed:(1996-2006.7),Cochrane Library (Issue 2 , 2006).We handsearched Chinese Journal of Orthopaedy (from establishment to May 2006) and Orthopaedic Journal of China (from establishment to May 2006). RCTs and CCTs were included.Data were extracted by two reviewers with designed extraction form.RevMan 4.2.8 software was used for data analysis. Results: Two RCTs and four prospective clinical trials were included.the combined results showed that compare with posterior surgical managements, anterior approach in the treatment of thoracolumbar fractures proved the less incidence of complications; better neurologic recovery and corrected kyphosis angle; more complete and reliable decompression of the canal. However, there was not difference between the two groups in the general status outcomes. Conclusion: To compare with posterior fixation system, anterior surgical managements in the thoracolumbar spinal trauma might be the optimal choices because the lower rates of complications and loss of corrected kyphosis angle; better neurologic recovery, also. Besides, due to the lack of Evidence-based guidelines for the treatment of Thoracolumbar spinal injuries, the results which indicated above need further study.