Anterior and anterolateral approaches to the lumbar spine in a developing country: about a series of 28 cases.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-03-14 DOI:10.1016/j.wneu.2025.123900

Assoumane Issa Ibrahim, Brice Audrey Sawa Nouga, Haboubacar Chaibou Sode, Agada Kpègnon Nicaise, Late Dzidoula Lawson, Nourou Dine Bankole Adeniran, Kelani Aminath

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引用次数: 0

Abstract

Background: The frequency of lumbar trauma in surgical emergencies at Niamey National Hospital is enormous. Injuries are most often amenable to an anterior or anterolateral approach, but due to a lack of expertise in surgical technique, they are usually operated on using a posterior approach.

Objective: To evaluate the management of lumbar spine fractures, including hinge fractures, using an anterior or anterolateral approach in a precarious context.

Patients and method: Retro and prospective observational descriptive study over 34 months including 28 patients who benefited from an anterior or anterolateral approach. The osteosynthesis material used was a bone graft fixed by a stainless-steel plate and screws. The mean follow-up was 3 months.

Results: Anterior and anterolateral approaches had a hospital incidence of 3.16%. At follow-up, there was no neurological deterioration, with an improvement in 75% of patients, despite deterioration of locoregional kyphosis in 76.92% of cases. One patient died in the immediate postoperative period and 1 died during medium-term follow-up.

Conclusion: The anterior approach to the spine is a therapeutic arsenal that needs to be mastered. Efforts are still required to acquire suitable equipment for correct sagittal balance.

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背景介绍在尼亚美国立医院的外科急诊中，腰部外伤的发生率非常高。大多数情况下，伤者都可以采用前路或前外侧入路，但由于缺乏手术技巧方面的专业知识，他们通常采用后路入路进行手术：评估在危险情况下采用前路或前外侧入路治疗腰椎骨折（包括铰链骨折）的效果：回顾性和前瞻性观察描述性研究，历时34个月，包括28名受益于前路或前外侧路的患者。使用的骨合成材料是由不锈钢钢板和螺钉固定的植骨。平均随访时间为 3 个月：结果：前方和前外侧入路的住院率为 3.16%。在随访中，尽管76.92%的病例局部脊柱后凸的情况有所恶化，但没有出现神经功能恶化，75%的患者病情有所改善。一名患者在术后即刻死亡，一名患者在中期随访期间死亡：结论：脊柱前路是一种需要掌握的治疗手段。仍需努力购置合适的设备，以实现正确的矢状平衡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS