Role of fixateur interne in thoracolumbar junction injuries

To evaluate the use of fixateur interne in thoracolumbar junction injuries.

An interventional descriptive study.

This study was conducted in the Department of Neurosurgery, PIMS from September 1996 to September 2001.

Seventy-nine patients with posttraumatic instability of lower thoracic or upper lumbar spine were surgically managed. Frankel grading was used to determine the neurological status of the patients. White and Panjabi criteria was used to determine the instability of the spine. All the patients with unstable spine undergoing surgery were included in the study. Open reduction and internal fixation using fixateur interne was done in all the cases. Changes in neurological status and complications were noted postoperatively and on subsequent follow-ups.

Most of the patients undergoing surgery were young. The commonest mode of trauma was due to fall in 59 patients. None deteriorated postoperatively. Initially, there were only 19 patients in Frankel E whereas at 1-year follow-up, there were 27 patients in Frankel E. On an average, there was 0.9 Frankel improvement. Average blood loss in an operation was 250 ml, average time for operation was 70 minutes and the average postoperative hospital stay was 7.9 days. There were 02 (2.5%) implant failures and their implants were removed. There were 02 (2.5%) cases of wound infection. The hardware was removed in one patient while in the other, the infection was controlled with antibiotics and wound debridement alone.

Fixateur interne may be useful choice for achieving reduction and stability in most thoracolumbar injuries for early ambulation and faster recovery.