Clinical Experience of New Surgical Technique for Reduction of Anterior Column in Hyperextension Injuries of Thoracolumbar Spine Associated with Diffuse Idiopathic Skeletal Hyperostosis

Abstract

Introduction: Patients with diffuse idiopathic skeletal hyperostosis (DISH) -related vertebral fracture may suffer from implant failure soon after an operation when they stand up. Insufficient repair in the anterior dilatation after prone fixation has been proposed behind this complication. We developed a new technic to avoid this complication.

Methods: In three cases of DISH-related vertebral fracture, which is not reduced in the prone position, we inserted the pedicure screw (PS) in the prone position. PS was inserted into each of the three vertebral bodies above and below the fracture, and then, we used four short rods to make each of the fixed vertebral bodies a lump and attached an open domino connector to each rod. After primary closure, put the patient in the forward flexed lateral decubitus position and reopen only between connectors. Finally, we attached other rods to each connector and fixed the fracture.

Results: No screw back out or neurological deterioration was observed after surgery in all cases.

Conclusions: This method is considered to be a useful technique for overextended DISH-related vertebral fractures of the thoracolumbar spine which is not reduced in the prone position.