Treatment of fractures and dislocations of the thoracic and lumbar spine by fusion and Harrington instrumentation

Abstract

Thirty-three patients with fractures of the thoracolumbar spine were treated by fusion and Harrington instrumentation after early reduction and stabilisation by postural reduction or halo-bifemoral traction. The rod-long-fuse-short technique was used. Postoperatively, all patients were mobilised with an external support. The mean follow-up was 6 years (range 1-13 years). Twenty-eight patients were pain-free, three patients needed sporadic pain medication. One patient was not working due to pain in his leg. One patient had constant pain. Twenty-three patients returned to work. The mean kyphosis increased from 8 degrees postoperatively to 13 degrees at follow-up.

Physical Rehabilitation of the Critically Ill Trauma Patient in the ICU

“…Surgical stabilization of spinal fractures, when indicated, allows for earlier mobilization (98)(99)(100)(101)(102)(103)(104)(105)(106)(107)(108), which is associated with a decrease in complications attributed to prolonged immobilization (109,110). Early surgical fixation of fractures less than 24 hours after injury may decrease length of stay by facilitating early mobilization (111).…”

The Successful Short-term Treatment of Flexion-distraction Injuries of the Thoracic Spine Using Posterior-only Pedicle Screw Instrumentation

“…In severe fractures, conservative treatment results in progressive kyphosis that correlates with neurologic deterioration and pain at follow-up. 15,16 Residual or progressive deformity of >17-degree focal kyphosis has been reported to carry a poor clinical prognosis. [24][25][26] The goal of operative intervention is to stabilize the spine, correct any focal kyphosis, prevent progression of the corrected kyphosis, and when indicated, decompress the neural elements.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Five surgical subgroups which included posterior short segment, posterior long segment, both posterior long and short segment, anterior and anterior combined with posterior were evaluated by Verlaan et al 1 in a recent review. Of the 17 purely thoracic fractures, 10 were corrected from posterior.…”

“…There is limited data reporting the results of the treatment of purely thoracic (T1-T10) FDI. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Various classification schemes have been devised in an attempt to define the mechanism of injury and treatment guidelines. [20][21][22][23] Denis' 3 column theory describes FDI as a failure of the middle and posterior columns under tension, and a possible failure of the anterior column under compression when the flexion force in association with an axis in the anterior column is generated.…”