Compression-distraction instrumentation of unstable thoracolumbar fractures: anatomic results obtained with each type of injury and method of instrumentation

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 1986-11, Vol.11 (9), p.895-902
• Main Authors: KEENE, J. S, WACKWITZ, D. L, DRUMMOND, D. S, BREED, A. L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Female; Fracture Fixation - instrumentation; Fracture Fixation - methods; Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; Humans; Injuries of the limb. Injuries of the spine; Laminectomy; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - injuries; Male; Medical sciences; Middle Aged; Radiography; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - injuries; Time Factors; Traumas. Diseases due to physical agents
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/00007632-198611000-00009

The quality of the reductions achieved in a consecutive series of 55 patients with unstable thoracolumbar fractures were correlated with the method of instrumentation, the type and level of injury, the effects of laminectomy and end-plate fractures, and the length of time from injury to surgery. It was found that many of these variables were associated with significant differences (less than 0.05) in the percent correction achieved in anterior compression, angle of deformity, and sagittal plane translation. Specifically: compression combined with distraction produced the best overall anatomic results, but bilateral compression and bilateral distraction were most effective for reducing flexion--distraction and flexion--axial compression (burst) fractures, respectively; two or more level laminectomies adversely affected reductions; end-plate fractures did not; the best reductions were obtained in flexion--distraction injuries; and the poorest reductions occurred in flexion--axial compression injuries, lumbar fractures, and fractures operated on 6 weeks or more after injury.