||Anterior decompression of the thoracic and lumbar
spine is indicated for patients with trauma, infection, or tumor that causes
compression of the neural tissues, resulting in an incomplete neurologic
deficit. The complication of chronic pain, with or without paralysis, that
results from fractures with canal compromise has received little attention.
This study involved 45 patients who had anterior decompression for chronic
pain or paralysis at an average of 4.5 years after having thoracolumbar
fractures. Pain was improved in 41 of 45 patients, with complete relief
in 30 and partial relief in 11. In 25 patients with neurologic deficit,
21 noted improvement, 14 of which improved one or more grades of the Eismont
classification. No patient had an increase in pain or loss of neurologic
function. Complications were few. Anterior decompression of the thoracolumbar
spine for chronic pain after thoracolumbar fractures is a safe and effective
treatment for patients with this uncommon and difficult problem.