[Application of Dick's Internal Fixation Device in the Treatment of Injuries of the Thoracolumbar Spine, First...

The authors treated 12 patients with injuries of the thoracolumbar spine, using an internal fixation device as designed by Dick. The advantage of Dick's device is: 1. fixation restricted to the smallest possible portion of the spine, usually only two mobile segments, 2. the possibility to influence the so-called anterior column of the spine from a posterior approach, 3. the possibility of peroperative reposition, 4. the high stability of the fitting, which makes possible early postoperative mobilization of the patient only with a removable orthesis. The internal fixation device makes it possible to perform other operations such as transpedicular spongio-plasty, posterolateral fusion or laminectomy and revision of the spinal canal. For surgical operation the following were indicated: 1. unstable fractures, 2. stable fractures with a neurological lesion and narrowing of the spinal canal revealed on CT. 3. stable fractures with a great deformity of the body, i.e. kyphotization or compression. The authors used the classification of Magerl et al., and classified the instability according to Louis. Posterior fusion was performed in all 12 cases, transpedicular spongioplasty in 10 patients, laminectomy and revision of the spinal canal in 3 cases. A neurological deficit of varying degree according to Frankel was recorded in 8 patients before operation. All improved after operation at least by one degree. The postoperative results restored in all patients the height and shape of the body of the vertebrae and the spinal curve. The authors did not observe any peroperative or early postoperative complication. Key words: spinal injury, transpedicular fixation, internal fixation device.