OBJECTIVETo investigate the feasibility and the efficacy of video-assisted thoracoscopic surgery in treating thoracolumbar fractures.

METHODSFrom October 2000 to December 2009, the data of 44 patients with thoracolumbar fractures were retrospetively analyzed. All patients were treated with anterior decompression, auto-iliac bone graft and anterior internal fixation system. They were divided into thoracoscopic group (23 cases, treated with video-assisted thoracoscopic surgery) and traditional group (21 cases, treated with traditional anterior approach surgery). In the thoracoscopic group, there were 15 males and 8 females with an average age of 41.4 years (ranged, 19 to 76); and in the traditional group, there were 14 males and 7 females with an average age of 39.3 years (ranged, 20 to 74). All patients were followed up from 6 to 36 months with an average of 18 months. The operative time, volume of the blood loss, the decreased value of the occupation ratio of spinal canal (OR), the corrected and loss degree of Cobb angle, the improved condition of ASIA classification were compared between two groups.

RESULTSIn traditional group, operative time, volume of the blood loss, the decreased value of the occupation ratio of spinal canal (OR), the corrected and loss degree of Cobb angle, the improved grade of ASIA classification were (150.0 +/- 19.4) min, (970.0 +/- 72.0) ml, (35.5 +/- 6.4)%, (25.1 +/- 4.8) degrees, (1.0 +/- 0.7) degrees, (1.8 +/- 0.9) grades, respectively; and in thoracoscopic group, the above items were (170.0 +/- 20.8) min, (650.0 +/- 65.4) ml, (33.2 +/- 8.0)%, (23.6 +/- 5.4) degrees, (1.1 +/- 0.8) degrees, (2.0 +/- 1.1) grades, respectively. There was significant difference in volume of the blood loss between two groups (P < 0.05); there was no significant difference in operative time, the decreased value of the occupation ratio of spinal canal (OR), the corrected and loss degree of Cobb angle,the improved grade of ASIA classification between two groups (P > 0.05). The rate of fusion of all patients was 100%.

CONCLUSIONCompared with the traditional anterior approach surgery, video-assisted thoracoscopic surgery has advantages of little incision,less blood loss, less trauma, can obtain same clinical outcome and is a safe,effective method in treating thoracolumbar fractures.