Jl. Stambough, COTREL-DUBOUSSET INSTRUMENTATION AND THORACOLUMBAR SPINE TRAUMA - A REVIEW OF 55 CASES, Journal of spinal disorders, 7(6), 1994, pp. 461-469
A series of 55 patients treated with posterior Cotrel-Dubousset instru
mentation and osteosynthesis for unstable thoracolumbar spine fracture
s were reviewed. Follow-up averaged 48.3 months. The fractures were al
l unstable, with 27 classified as fracture-dislocations (FD) and 28 cl
assified as flexion compression injuries or unstable burst fractures (
FC/B). The study population was composed of 29 men and 26 women with a
n average age of 31 (range 20-45) years. Mechanisms of injuries includ
ed 35 motor vehicle accidents, 19 falls, and one blunt trauma. No case
worsened as a result of surgery, and 31% of the cases improved an ave
rage of 0.5 Frankel grade (range 0-2). Sixty percent of patients were
braced with a custom molded thoracolumbosacral orthosis (TLSO) fitted
after surgical stabilization. Minor complications occurred in 45% of t
he cases (urinary tract infection most common). There was a singular d
eep wound infection and another iliac crest donor site infection. Ther
e were no instrument failures or pseudarthroses. Radiographic analysis
showed the following improvements in fracture angle, vertebral body c
ompression, and fracture displacement. The pattern of radiographic imp
rovement in the FD and FC/B subgroups showed significant improvement i
n each parameter when comparing preoperative to immediate postoperativ
e values. Of importance, the radiographic findings comparing 1 month t
o the final follow-up showed little to no deterioration. Cotrel-Dubous
set instrumentation proved to be a highly effective device for immedia
te restabilization of unstable thoracolumbar injuries.