A comparison of Harrington rod fixation with and without segmental wires for unstable thoracolumbar injuries.
Between January 1, 1975 and November 1, 1986, 77 patients with acute unstable thoracic or lumbar spine fractures underwent reduction, posterior stabilization with dual Harrington distraction rods, and fusion with autogenous iliac crest bone graft at Vanderbilt University Medical Center. Beginning March 1985, in 25 patients, segmental interspinous wires were employed, in addition to the Harrington rods, to augment the surgical construct. Clinical and radiographic analysis was performed to determine if differences existed between the two groups. Average time to surgery, hospital stay, and time to brace discontinuance were lower in the segmental wire group. Pain and work status at final follow-up were similar in the two groups. There was a higher incidence of superior and inferior hook migration and reoperation for this complication in patients treated with Harrington rods alone. There was no significant difference in postoperative correction of deformity, although at follow-up, there was greater recurrence of deformity in the Harrington rod group. In summary, the use of segmental wires to supplement Harrington rod fixation appears to offer advantages over Harrington rods alone, with minimal or no increased risk.
Phillips
D L
DL
Vanderbilt University Medical Center, Nashville, Tennessee.
Brick
G W
GW
Spengler
D M
DM
D000293:Adolescent; D001858:Bone Nails; D001864:Bone Wires; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008875:Middle Aged; D009420:Nervous System / Q000503:physiopathology; D011183:Postoperative Complications; D011184:Postoperative Period; D011859:Radiography; D012086:Reoperation; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013131:Spine / Q000000981:diagnostic imaging; D013904:Thoracic Vertebrae / Q000293:injuries*