The fixateur interne in the reduction and stabilization of thoracolumbar spine fractures in patients with neurologic deficit.
A prospective analysis of 80 consecutive patients who underwent stabilization with the fixateur interne for thoracolumbar spine fractures with complete or incomplete paraplegia was undertaken to determine the results after bone healing. Follow-up examination at an average of 35 months (minimum, 24 months) included all 76 patients still alive. One patient died from a pulmonary embolism, and there were three other unrelated deaths. The mean wedge angle of the fractured vertebra was corrected from 17.4 degrees to 7.9 degrees and remained almost unchanged after 1 year (8.4 degrees) and 2 years, or 1 year after implant removal (8.2 degrees). Also, the wedge index showed nearly no bony loss of correction within the reduced fracture vertebra (0.61 before operation, 0.83 after operation; 0.81 at 1-year follow-up, 0.81 at 2-year follow-up, respectively). In the kyphosis angle measured by the Cobb method, however, there was a loss of 5 degrees after implant removal within the next year because of the disc space collapsed above the fractured vertebra. In this series, 70% of the cases had no formal fusion. All 29 cases of translational displacement of 4-36 mm were anatomically reduced. No neurologic or vascular complication occurred. Posterolateral fusion or transpedicular interbody fusion in the disrupted disc space is recommended.
Lindsey
R W
RW
Division of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas.
Dick
W
W
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D010264:Paraplegia / Q000209:etiology; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000293:injuries*; D013997:Time Factors