Thoracolumbar fracture dislocation: a study of 30 patients

Open reduction and wiring of the spinous processes were carried out in patients with a thoracolumbar fracture dislocation. Clinical and X-ray examinations were performed on 30 patients 5 or more years following operation. At the time of the initial examination, an anterior angulation of 30 degrees or more was noted in 18 patients, but only in 4 cases at the time of the follow-up examination. Anterior displacement of the vertebral bodies was seen in 30 patients, but it was found to be normal in 26 patients at the time of follow-up. There were 7 patients with lateral angulation of 5 degrees or more, but only 2 patients at the time of follow-up. Lateral displacement of 5 mm or more was observed in 10 patients, but only 3 patients could be seen at the time of follow-up. In comparison with spinal instrumentation with the use of large long metallic materials, wiring of the spinous processes has several advantages such as limited surgical invasion, firm fixation, no effect on spinal mobility and no need for repeat surgery for removal of metallic materials. It is an adequate alternative method for the internal fixation of rotational fracture dislocations of the thoracolumbar region of the spine, without fracture of the posterior wall of the vertebral body and pedicle fracture.