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After all the treatment options were explained, 20 (of the 75) patients with severe canal compromise anterior column disruption and posterior ligamentous complex (PLC) disruption were selected to undergo surgery using a posterior-only approach consisting of a transpedicular corpectomy with anterior column reconstruction via expandable-cage placement and posterior instrumentation and fusion.
The PSO with a cage method includes inserting a cage with bone autograft into the osteotomy space in the anterior column of the osteotomized vertebra.
A relative reduction may occur with either: 1) large tongue volume relative to the volume of the bony limits of the anterior column or 2) prominent top incisors requiring more mandibular protrusion during direct laryngoscopy.
Because the anterior columns remain intact, this fracture is considered mechanically stable.
Underlying bone quality is different, and activities have changed in the elderly, resulting in the generation of a different set of fracture patterns with a predominance of anterior column damage combined with often incomplete posterior fractures [26].
"By utilizing an oblique lateral approach to the spine, this procedure enables placement of a large interbody graft into the disc space for anterior column support and segmental sagittal alignment while minimizing the nerve, muscle, and bone obstacles associated with traditional direct lateral approaches."
(5) This alteration has significant adverse sequelae in that it places additional stress on the posterior paraspinal muscles and ligaments, predisposes to a loss of balance, and places additional stress on the anterior column such that adjacent and other vertebrae are at risk for compression.
For the long-term health of soil tissues and facets, the elasticity of the anterior column unit should be restored to normal physiologic ranges.
described the case of a 15-year-old hockey player who sustained a non-displaced bilateral anterior column and wall acetabular fracture after low-energy trauma that was managed conservatively.
[6] reported in 2001 that the anterior column of the thoracic spine could easily be assessed and reconstructed using a minithoracotomy and a table-mounted retractor.
The potential complications caused by SPO include paraplegia from spinal kinking, cauda equina compression, and abdominal vessel injury from stretching of the anterior column. Some surgeons have modified SPO into a more posterior column resection and anterior osteoclasis and have achieved over 30[degrees] of correction at one level.[sup][8] It should be noted that SPO is susceptible to sagittal translation of the spinal column, which can cause cord compromise.

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