[Combined surgery for fractures of the thoraco-lumbar junction using the inlay-span method]

The combined intervention of thoracolumbar fractures using the graft inlay technique. Instable fractures of the thoracolumbar junction must be reduced in an open or closed fashion and fixed internally. Clearance of the spinal channel in case of obstruction is mandatory followed by reconstruction of the anterior part of the spine. Using the combined interventions of transpedicular screw techniques and antero-lateral approaches (transthoracal or retroperitoneal) instable fractures of the thoracolumbar junction can be fixed in comparison to the dorsal intervention the anterior approach is very demanding. The proximity of the big vessels as well as thoracal and abdominal organs and the available space to place the implants need exact preoperative planning. The indications for reconstruction of the anterior part of the spine are influenced by the fracture types and localisations as well as biomechanical considerations. One of the many possibilities to reconstruct the anterior part of the spine is the graft inlay technique, which can be used for mono- or bisegmental spondylodesis. Despite the biological advantages in terms of fusion rates substantial complications can occur using this method for anterior reconstruction of the spine.