Skip to main content
Log in

Comparative study of different dorsal stabilization techniques in recent thoraco-lumbar spine fractures

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

The authors initially outline the development of operative techniques to stabilize traumatic thoraco-lumbar spine fractures.

Thereafter their own results in 125 patients, treated operatively between 1.1.1983 and 15.9.1988, are presented.

The different techniques (Harrington-instrumentation, transpedicular plate stabilization, fixateur interne) are evaluated. In the clinical neurological examination 25% of the patients experienced an improvement by at least one point in the FRANKEL classification. Four patients suffered neurological deterioration.

In the radiological follow-up the “Sintering” process, the kyphotic and scoliotic deformity of the spinal segment were measured. The fixateur interne had the best overall results (loss of reposition averaged a kyphosis of 6.8 °, no fracture instability). Less good results were obtained with both the Harrington stabilization (loss of reposition 9.1 °, fracture instability in 3 cases) and with the transpedicular plate stabilization (loss of reposition 12.4 °, fracture instability in 2 cases).

Finally the complications are described. The optimal approach is based on the clinical development. The fusion should be as short as possible with a stable angle implant and the possibility to reposition intraoperatively should be given. Postero-lateral spongiosa application, fusion of the vertebral arch joints, diskectomy with transpedicular spongiosa application and intercorporal blocking should be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aebi M, Mohler J, Zaech G, Morscher E (1986) Analysis of 75 operated thoracolumbar and fracture dislocations with and without neurologic deficit. Arch Orthop Trauma Surg 105: 100–112

    Article  PubMed  Google Scholar 

  2. Been HD, Slot GH (1988) Indications, technics and results of the surgical treatment of thoracolumbar spinefractures with the SLOT-ZIELKE-System. In: Die Wirbelsäule in Forschung und Praxis Bd. 107. Hippokrates, Stuttgart, pp 96–105

    Google Scholar 

  3. Blauth M, Tscherne H, Gotzen L, Haas N (1987) Ergebnisse verschiedener Operationsverfahren zur Behandlung frischer Brust- und Lendenwirbelsäulenverletzungen. Unfallchirurg 90: 260–273

    PubMed  Google Scholar 

  4. Daniaux H (1986) Transpedikuläre Reposition und Spongiosaplastik bei Wirbelkörperbrüchen der unteren Brust- und Lendenwirbelsäule. Unfallchirurg 89: 197–213

    PubMed  Google Scholar 

  5. Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8: 817–829

    PubMed  Google Scholar 

  6. Dick W (1984) Innere Fixation von Brust- und Lendenwirbelfrakturen. In: Aktuelle Probleme in Chirurgie und Orthopädie. Bd. 28. Huber, Bern

    Google Scholar 

  7. Dick W, Zack GA (1987) Operative Sofortbehandlung mit dem Fixateur interne bei Brust- und Lendenwirbelfrakturen mit Querschnittslähmung: Ergebnisse bei 90 Patienten. Hefte Unfallheilkd 189: 655–657

    Google Scholar 

  8. Dörner A, Mommsen U, Müller S, Jungbluth KH (1985) Frakturen der Lendenwirbelsäule und unteren Brustwirbelsäule — operative Technik und Ergebnisse. Unfallchirurg 11: 1–6

    Google Scholar 

  9. Frankel HL, Hancock DO, Hyslop G, Melzak J, Michaelis LS, Ungar GH, Vernon JDS, Walsch JJ (1969) The value of postural reduction in the intitial managment of closed injured of the spine with paraplegia and tetraplegia. Paraplegia 7: 179–192

    PubMed  Google Scholar 

  10. Hadra BE (1891) Wiring of the vertebrae as a mens of immobilization in fracture and Pott's disease. Medical Times and Register 22: 423–430 Reprint: Clin Orthop 112: 4–11

    Google Scholar 

  11. Harrington PR (1962) Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg 44 A: 591–602

    Google Scholar 

  12. Harrington PR (1967) Instrumentation in spine instability other than scoliosis. S Afr J Surg 5: 7–16

    PubMed  Google Scholar 

  13. Harrington PR (1972) Technical details in relationship to the successful use of instrumentation in scoliosis. Orthop Clin North Am 3: 49–61

    PubMed  Google Scholar 

  14. Holdsworth FW, Hardy A (1953) Early treatment of paraplegia from fractures of the thoracolumbar spine. J Bone Joint Surg 335 B: 540–553

    Google Scholar 

  15. Jacobs RR, Asher MA, Snider RK (1980) Dorsolumbale Wirbelsäulenfrakturen — eine vergleichende Studie zwischen konservativer und operativer Behandlung bei 100 Patienten. Orthopäde 9: 45–62

    Google Scholar 

  16. Jodan A, Dupuis P, Fraser M, Beaumont P (1985) Unstable fractures of the thoracolumbar spine: A 10-year experience at SACRE-COEUR HOSPITAL. J Trauma 25/3: 197–202

    Google Scholar 

  17. Kahanovitz N, Bullough P, Jacobs RR (1984) The effect of internal fixation without arthrodesis on human facet joint cartilage. Clin Orthop 189: 204–211

    PubMed  Google Scholar 

  18. Kluger P, Gerner HJ (1986) Das mechanische Prinzip des Fixateur externe zur dorsalen Stabilisierung der Brust- und Lendenwirbelsäule. Unfallchirurg 12: 68–79

    PubMed  Google Scholar 

  19. Kornberg M, Rechtine G, Herndon W, Reinert C, Dupuy T (1984) Surgical stabilization of thoracic and lumbar spine fractures: A retrospective study in a military population. J Trauma 24/2: 140–146

    Google Scholar 

  20. Lifeso R, Arabie K, Kadhi S (1985) Fractures of the thoracolumbar spine. Paraplegia 23: 207–224

    PubMed  Google Scholar 

  21. Louis RC (1982) Chirurgie du Rachis. Anatomie chirurgicale et voies d'abord. Springer, Berlin Heidelberg New York

    Google Scholar 

  22. Magerl F (1979) Die Behandlung von Wirbelsäulenverletzungen. In: von Wayand E, Brücke P (Hrsg) Kongressbericht 19. Tgg OEST Ges f Chirurgie, Bd. 2 H. Egermann, Wien, pp 859–870

    Google Scholar 

  23. Magerl F (1981) Clinical application on the thoraco-lumbar junction and the lumbar spine with a fixateur externe. In: von Mears DC (ed) External skeletal fixation. Williams and Wilkins, Baltimore, pp 553–565

    Google Scholar 

  24. Magerl F (1982) External skeletal fixation of the lower thoracic and the lumbar spine. In: von Uhthoff HK (ed) Current concepts of external fixation of fractures. Springer, Berlin Heidelberg New York, pp 353–364

    Google Scholar 

  25. Magerl F (1982) Stabilisierung der unteren Brust- und Lendenwirbelsäule mit dem Fixateur externe. Acta Chir Austriaca [Suppl] 43: 78–87

    Google Scholar 

  26. Mc Afee PC, Yuan HA, Lasda NA (1982) The unstable burst fracture. Spine 7: 365–371

    PubMed  Google Scholar 

  27. Nash CL, Schatzinger LH, Brown RH, Brodkey J (1977) The unstable thoracic compression fracture: its problems and the use of spinal cord monitoring in the evaluation of treatment. Spine 6: 13–20

    Google Scholar 

  28. Robert PH (1969) Internal metallic splintage in the treatment of traumatic paraplegia. Injury 1: 4–11

    Google Scholar 

  29. Roberts JB, Curtiss PH (1970) Stability of the thoracic and lumbar spine in traumatic paraplegia following fracture or fracture-dislocation. J Bone Joint Surg (Am) 52: 1115–1121

    Google Scholar 

  30. Roy-Camille R, Berteaux D (1976) Technique et résultats des ostéosynthèses du rachis lombaire par plaques — postérieures vissées dans les pédicules vertébraux. Montpellier Chir 22: 307–315

    Google Scholar 

  31. Roy-Camille R, Saillant G, Marie-Anne S, Mamoudy P (1980) Behandlung von Wirbelfrakturen und -luxationen am thorakolumbalen Übergang. Orthopäde 9: 63–68

    Google Scholar 

  32. Stoltze D, Harms J, Winnerlein M, Nanassy G (1987) Operative Behandlung frischer Wirbelsäulenverletzungen mit Querschnittslähmung. Hefte Unfallheilkd 189: 657–660

    Google Scholar 

  33. Williams EWM (1963) Traumatic paraplegia. In: Matthews DD (ed) Recent advances in the surgery of trauma. Churchill, London, pp 171–186

    Google Scholar 

  34. Wolter D (1984) Wirbelsäulenplatten-Modell “St. Georg”, Verkaufskatalog der Fa. W. Link, Hamburg

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eysel, P., Meinig, G. Comparative study of different dorsal stabilization techniques in recent thoraco-lumbar spine fractures. Acta neurochir 109, 12–19 (1991). https://doi.org/10.1007/BF01405690

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01405690

Keywords

Navigation