COTREL-DUBOUSSET INSTRUMENTATION IN THORACOLUMBAR SEAT BELT-TYPE AND FLEXION-DISTRACTION INJURIES

For many years, all the internal fixation devices available for the su rgical treatment of thoracolumbar fractures [Harrington rods (HR); Luq ue rods (LR); Hartshill rectangle (HTR); Roy Camille plates (RCP)] wer e not always able to distribute alt the reductive strains (distraction , compression, derotation), or to guarantee solid stabilization withou t external supports. In some cases (with HR), only distraction forces might be applied, but stability of the assembly was very poor. Otherwi se (with LR, HTR, or RCP), stability was well achieved using segmental fixation systems (with SSW, screws), but reduction was possible only by deflecting the spine towards the rods (or plates), by winging the s ublaminar wires (or screws). Restoration of normal sagittal alignment was also very difficult to obtain. The use of internal fixation system s for reduction of thoracolumbar fractures when distraction or compres sion forces are needed are essential for the spinal surgeon and the pa tient. In some cases of thoracolumbar fractures (seat belt; flexion-di straction), in fact, the use of distraction forces is not suitable, le ading only to overdistraction, not to reduction. The introduction of C otrel-Dubousset instrumentation (CDI) in 1983, and its subsequent use in spinal traumatology, seems to answer all these unresolved questions .