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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