STABILIZATION OF 150 UNSTABLE SPINAL-INJURIES WITH THE COTREL-DUBOUSSET INSTRUMENTATION TECHNIQUE - ANALYSIS OF RESULTS

The present study is a retrospective analysis of spinal fracture treat ment with the Cotrel-Dubousset instrumentation technique. 150 unstable injuries of the spine were treated with the CD implant at the Univers ity of Louisville-Level I Trauma Center - between Februar 1985 and Mar ch 1989. There were 67 burst fractures, 48 compression fractures and 2 1 fracture dislocations, 8 flexion distraction fractures and 6 flexion rotation injuries. Ninety-three patients underwent anterior cord deco mpression and strut grafting followed by posterior CD instrumentation and posterolateral fusion. Fiftyseven patients had posterior CD instru mentation and fusion alone. No neurological deterioration after the pr ocedure was observed, 33 patients improved neurologically. Hospital st ay ranged between 7 and 60 days (mean 20 days). 114 patients had a min imum follow up of 6 months (range 6 - 52 months) The mean follow up wa s 17.7 months. At final follow up 77.8 % of the patients had returned to work and 84.2 % of the patients were almost painfree. The mean loss of correction in the sagittal plane was 6.2 degrees (range: 0 and 42 degrees) at final follow up. As technical complications there were hoo k cut outs (2.6 %) of which two underwent reosteosynthesis and two did not effect the clinical or radiographic result. The high stability of the device provides a decreased risk of neurological deterioration. a decreased risk of post-traumatic kyphosis and early rehabilitation.