ANTEROLATERAL DYNAMIZED INSTRUMENTATION AND FUSION FOR UNSTABLE THORACOLUMBAR AND LUMBAR BURST FRACTURES

Study Design. A retrospective chart review of 36 patients treated with dynamized anterolateral instrumentation and fusion after decompressio n for thoracolumbar and lumbar burst fractures is presented. Objective s. To evaluate a device that allows continual bone graft vertebral end plate compression and determine its potential for healing in patients with thoracolumbar and lumbar burst fractures. Summary of Background D ata. Anterior spinal surgery has led to implant adaptations. Such impl ants have undergone an evolution in hopes of improving the rate of hea ling and avoiding neurovascular catastrophes. Methods. Thirty-six pati ents underwent anterior decompression dynamized instrumentation and fu sion for thoracolumbar and lumbar burst fractures. This involved a dua l-rod, quadrilateral, cross-linked frame that allows for continual com pression but deters rotation and shear stresses. Results. All patients healed solidly without instrumentation failure. An average recovery o f 1.3 Frankel grades was recorded. Subsidence of bone graft vertebral endplate was less than in those placed in a trough. Conclusions. Dynam ized load-sharing anterolateral Cotrel-Dubousset instrumentation led t o solid bone graft healing without implant failure by allowing continu al compression while deterring shear and rotational stresses.