Spinal Stabilization Using Orthopedic Extremity Instrumentation Sets During Operation Enduring Freedom-Afghanistan

Area of Science:

• Orthopedic surgery
• Combat casualty care
• Spinal fusion techniques

Background:

• Role III, Multinational Medical Unit in Kandahar provided combat casualty care during Operation Enduring Freedom-Afghanistan.
• Treatment of unstable lumbar spine fractures was performed between January 2007–January 2008 and November 2010–May 2011.

Purpose of the Study:

• To describe the experience of treating unstable lumbar spine fractures using orthopedic extremity instrumentation sets.
• To evaluate the efficacy and safety of using non-spinal instrumentation for spinal stabilization in a resource-scarce combat environment.

Main Methods:

• 15 patients with unstable lumbar spine fractures underwent surgical treatment.
• Procedures included anterior corpectomy and instrumented fusion (n=5) or posterior instrumented fusion (n=10).
• Orthopedic extremity instrumentation sets were utilized due to scarcity of dedicated spinal sets.

Main Results:

• Postoperative radiographs showed no fracture progression or hardware failure.
• One patient exhibited stable spinal construct at 4-week follow-up.

Conclusions:

• Unstable spine fractures can potentially be treated with non-spinal instrumentation in austere combat settings.
• This represents an off-label use and is not recommended as standard practice in most medical environments.