USE OF LONG RODS AND A SHORT ARTHRODESIS FOR BURST FRACTURES OF THE THORACOLUMBAR SPINE - A LONG-TERM FOLLOW-UP-STUDY

Thirteen patients who had a burst fracture of the thoracolumbar spine (the twelfth thoracic to the fifth lumbar vertebra) were managed with the use of long rods and a short arthrodesis (the so-called rod-long, fuse-short technique). The patients were followed for an average of se venty-four months (range, thirty-four to 118 months). Six months after the operation, the rods mere removed and the fusion mass was explored . At that time, twelve patients had a solid fusion at all levels of th e arthrodesis. Of the eighty-eight facet joints that had been spanned by the rods but had not been included in the arthrodesis, two had neve rtheless progressed to fusion, as determined radiographically. Physiol ogical motion was present in forty-three of the forty-four segments fo r which a fusion had not been intended. Before the operation, the aver age anterior height of the fractured vertebrae was 61 per cent of the estimated height before the injury; this improved after the operation to an average of 83 per cent (median, 87 per cent) of the height befor e the injury. At the latest follow-up examination, the anterior height was an average bf 78 per cent of the estimated height before the inju ry (median, 82 per cent; range, 51 to 93 per cent), a slight decrease compared with the value immediately after the operation. Kyphosis of t he injured segment before the operation, measured for twelve of the th irteen patients, averaged 15 degrees (median, 12 degrees; range, 0 to 33 degrees); as a result of the operation, this improved an average of 15 degrees, to 0 degrees of kyphosis. At the latest evaluation, the a verage kyphosis of the injured segment was 9 degrees (median, 10 degre es; range, -11 to 23 degrees). Nine patients lost more than 7 degrees of the initial correction. Residual back pain was absent or mild in te n patients and moderate in three. Eleven patients had returned to the pre-injury level of employment or active retirement, or they were work ing full-time at a different job, indicating a satisfactory functional outcome in this series.