[Use of transpedicular fixation in treatment of thoraco-lumbar spinal injuries]

In Orthopaedic University Department in Lublin in years 1993-1998 39 patients with thoraco-lumbar spine injuries were treated including 34 fractures and 5 luxations. All of them were treated by surgery. Complete neurological palsy (Frankel A) occurred in 16 patients. Grade E on Frankel scale e.g. no neurological symptoms was in 2 cases. The operations consisted of wide laminectomy with interpedicular joints resection. It gave chance to mobilise the dural sac with its contents. In this situation it was possible to remodel the anterior wall of spinal canal by removal of fractured bony pieces from vertebral body or fibroid remnants of damaged disc. Injured segments of the spine were stabilized by Kluger's fixateur. In 20 cases reduction of vertebral body fracture and filting of bone loss by autogenic spongiosa grafts from iliac crest as proposed by Daniaux was done. In 6 patients posterior interbody spondylodesis was done also with iliac crest grafts. In 9 patients who had only reduction of injured segments, without vertebral body reconstruction and spondylodesis loss of correction occurred after fixateur removal. In 3 patients fatigue break of screws or stabilizing rods developed. It happened 12-16 months after surgical procedure. In patients with primary complete neurological palsy from the level of injury (Frankel A) no symptoms of function improvement appeared higher than one grade in Frankel's scale.