This study evaluated the clinical results of surgical treatment for thoracolumbar spine fracture.
The subjects were 26 males and 3 females with a mean age of 47 years ranging from 18 to 74 years. The duration of the follow-up varied from 4 months to 72 months, with a mean of 2 years and 4 months. The most common site of injury was L1, which accounted for 55% of the injuries (16/29 cases). The causes of the injuries were 16 falls, 8 traffic accidents, and 5 heavy mass drops. Four kinds of instuments (Roy Comille plate: 16 cases, Kaneda device: 5, Compact CD: 2, Spine system: 6) were used. We operated by the anterior approach for 5 cases, by the posterior approach for 15 cases, and by the anterior/posterior approach for 9 cases.
47 percent of the patients showed improvement of neurological deficits, increcsing by one rank by the Frankel classification. Although no cases deteriorated, 3 patients with complete paraplegia did not improve at all at the time of follow-up. The correction angle in 41 percent of the patients (12/29 cases), which was acquired by operation, decreased radiographically more than 6 degrees at the time of follow-up. No difference was seen in the correction loss between each implant or between each approach. We observed 11 fractures of the extremities, 3 pelvic fractures, 3 head injuries, 4 pulmonary hemorrhages with rib fractures, a cord injury of the cervical spine, a crush syndrome, and a fat embolism syndrome preoperatively. We recognized 8 doner site troubles, a sudden raputure of spleen, a numbness of prineum, etc postoperatively. 10 instrument failures (R-C plate: 6: cases, K-device: 2, CCD: 1, S-system: 1) were found at the time of follow-up. 4 out of 5 screw breakages were R-C plate system, because the screw diameter of R-C was smaller than others.
