Computed tomography of thoracic and lumbar spine fractures that have been treated with Harrington instrumentation

Twenty patients with fractures of the thoracic and lumbar spine underwent computed tomography (CT) following Harrington distraction instrumentation and spinal fusion. CT was done to search for a cause of persistent cord or nerve root compression in those patients who failed to improve and completely recover their partial neurologic deficit (14 cases). In 6 patients seen in the late recovery period, CT was performed to evaluate the causes of pain and instability at the fracture site. Even though the image was degraded due to the artifacts generated by the metallic rods, significant information was available in each case. The most common abnormality was the presence of residual bone fragments originating in the burst fracture of a vertebral body displaced posteriorly, into the spinal canal. In patients with complications in the late recovery period, CT found exuberant callus indenting the canal or lack of fusion of the bone grafts placed in the anterolateral aspect of the vertebral bodies. This experience indicates that CT is the modality of choice for spinal canal evaluation in those patients who fail to have an optimal clinical course following fractures of the thoracic and lumbar spine treated with Harrington rods.