RECURRENT KYPHOSIS AFTER POSTERIOR STABILIZATION OF THORACOLUMBAR FRACTURES - 24 CASES TREATED WITH A DICK INTERNAL FIXATOR FOLLOWED FOR 1.5-4 YEARS

24 patients with Th12-L1 fractures treated with a Dick internal fixato r were analyzed to assess predictors of poor outcome. 4 patients had f ixation without bone transplantation, 20 patients had a posterior fusi on, and 12 of them had additional transpedicular spongioplasty. There were fractures of the transpedicular screws in 4 and screw migration i n 2 cases. The increase in the local kyphosis angle was greater than t he increase in the anterior compression angle and this did not correla te with spongioplasty or fusion. Fixation failure was in all cases rel ated to a disproportionate increase in the local kyphosis angle. There was no difference between the patients with transpedicular spongiopla sty and posterior fusion and the other patients with respect to result s and complications. Bony collapse was not the major cause of failure and consequently there was no measurable contribution of transpedicula r spongioplasty. We found that the Dick internal fixator for unstable fractures was associated with a higher complication rate than earlier reported.