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Wheeless' Textbook of Orthopaedics
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Anterior Approach for Lumbar Burst Frx




- Discussion:
    - most indicated for unstable burst frxs w/ cord impingement caused by bone fragments off
            the postero-superior vertebral body;
    - allows most direct visualization for decompression of thecal sac;
    - visceral and vascular structures may be injured, & this approach carries the greatest potential morbidity;
    - anterior strut grafting w/ iliac crest is required but often provides only minimal immediate stability,
            unless anterior fixation is also applied;
    - after anterior procedure, posterior compression instrumentation & arthrodesis will help
            increase stability of anterior graft, increase the probability of successful fusion;

- Thoracolumbar Surgical Approach:

   












Original Text by Clifford R. Wheeless, III, MD.