Reduction of the intracanal fragment in experimental burst fractures

An experimental investigation was carried out to create burst fractures and to evaluate the mechanisms and degree of reduction of the intracanal fragment with posterior instrumentation techniques in multisegmental human cadaver specimens. Reduction of the spinal fragment through kyphosis correction and distraction was evaluated using CT imaging. With kyphosis correction alone there was no decrease in canal compromise; in some cases there was a slight increase in canal compromise. Distraction, whether applied before or after kyphosis correction was the effective mechanism in reducing the fracture fragment. Kyphosis correction applied after distraction did not reduce the fragment further. Posterior devices that are used to treat burst fractures of the thoracolumbar spine with intracanal fragments should provide some form of distraction.