The results of treatment of six patients, five males and one female, with unstable thoracolumber fracture and dislocaion are reported.
The sites of injury were thoracolumbar spine in four patients and lumbar spine in two paients. Five of six patients showed neurological deficit after injury. Two patients underwent open reduction and Harrington instrumentation within twelve hours of injury; two, after twenty four hours of injury; one, after six days; and one, after 82 days with pediculectomy for lateral decompression, after this procedure anterior spinal fusion was achieved. Three of five patients with nourological change showed neurological recovery, including one patient with lateral fracture and dislocation of low lumbar spine, who was operated on after 82 days of injury. Other two patients with complete damage on low thoracic spinal cord remained almost unchanged. One stage operation with Harrington instrumentation and anterior spinal fusion was performed in one patient who showed no neurological deficit.
In conclusion, neurological improvement was obtained after the first surgery with open reduction and Harrington instrumentation in incomplete paraplegic patients, and anterior spinal fusion was necessary for further good stability of the spine.
