Treatment of Fracture of the Thoraco - Lumbar Spine using Cotrel - Dubousset Implant

Kim, Yong Ju; Yoon, Suk Woong; Lee, Bum Koo; Shin, Young Shik

Abstract

The main goals of surgical teatment of thoracolumbar vertebral fractures are to achieve reduction, stability and early, painless mobilization. A further aim is to avoid late malposition and to preserve mobility and lordosis. The main disadvantage of Harrington instrumentation and similar methods are that this device fixate five to seven vertebrae. The Cotrel-Dubousset(C-D) instrumentation provides a stable construct for fixation of spine fracture. The advantages of C-D pedicle screw for thoracolumbar spinal fractures are that compression or distraction force can be applied in the same rod and used to achieve anatomical reduction of spinal fractures and rigid fixation can be obtained with short instrumentation. The C-D instumentation was done for 15 unstable thoracolumbar spinal fractures at Seoul Red Cross Hospital from January, 1988 to January, 1990. The results were as follows. 1. The most common cause of the spine fracture was fall down, and majority are within 20-40 old age. 2. The most common involved site was T12 and Ll vertebrae (66.7%). 3. The most common type of injury was burst fracture by according to Denis classification(60%). 4. The complication was developed mostly in neurological deficient patient. 5. The advantage of the C-D instrumentation: (1) rigid and short osteosynthesis of spine fracture, (2) compression or distraction force can be applied in the same rod, (3) early mobilization with a brace is possible. 6. The rigid fixation can be obtained.