Intraoperative ultrasonography for reduction of thoracolumbar burst fractures

The purpose of this study was to determine the efficacy of intraoperative ultrasound monitoring in the reduction and stabilization of thoracolumbar burst fractures of the spine. Thirty-one patients underwent a posterior approach for reduction and stabilization of a thoracolumbar burst fracture, with complete follow-up available on 26. Intraoperative real-time sonography was used for monitoring retropulsed fragments during distraction and fracture impaction. Computed tomography was used to compare preoperative canal compromise and postoperative reduction. Average canal compromise preoperatively was 66.5%, and the average canal compromise postoperatively was 18.7%. Neurologic function was not changed in 16, improved in ten, and worsened in none. Average hospital stay was 21.6 days. No complications were directly attributable to the use of the ultrasound. The authors believe that ultrasonography provides a safe and accurate method of intraoperatively evaluating reduction of burst fracture of the thoracolumbar spine from the posterior approach.