Treatment of the Unstable Thoracolumbar Fractures Using Cotrel - Dubousset Instrumentation

Park, In Heon; Lee, Kee Byoung; Park, Myung Ryool; Lee, Jin Young; Lee, Deuk Yong

Abstract

Surgical stabilization using instrumentation for thoracolumbar injuries offers several advantages such as nearly anatomic reduction of fractures, protection of neurologic structures and most importantly early ambulation of the patient. The treatment of fracture-dislocation of the thoracolumbar spine has been progressively improved over the past decades and recently a lot of new device have been introduced to improve fixability of the involved vertebrae three dimensionally and short segmental fixation as possible. The authors have treated 17 cases of unstable thoracolumbar fracture using Cotrel-Dubousset instrumentation in the Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital from Jan. 1988 to Jan. 1989 with the following results: 1. Bursting fractures are the most common type(52.9%) of mechanism of injury. 2. Excellent anatomic reductions were obtained and compression, wedging and local kyphotic deformities were nicely corrected. 3. Short segmental fixation can preserve the maximal spinal mobility. 4. No significant loss of reduction or loosening of implant was found. 5. Remarkable neurologic recoveries were observed in cases of incomplete cord lesion. 6. Significant neurologic recovery was found in patients treated with laminectomy and Cotrel-Dubousset instrumentation.