A comparative analysis of distraction rods versus Luque rods in thoracic spine fractures

The findings of this study emphasize the importance of distraction in obtaining and maintaining reduction in upper thoracic fractures that are unstable and collapsing into kyphosis. It also shows that a Luque rectangle construct cannot fulfill this function adequately in this type of fracture. Thirty-four consecutive cases of surgically treated upper thoracic spine fractures were reviewed. Two patients died, and 4 were lost to follow-up, so after a minimum 6-month clinical and radiographic follow-up there were 11 patients in the Luque group and 17 in the distraction rod group. Preoperatively, there was no significant difference in age, sex, level of injury or severity of kyphosis between the two groups. The Luque stabilization took an average of 1 h longer. There was no difference in local, general or neurological complications between the groups. Pain at the final follow-up was the same according to analgesic use. The kyphosis in the Luque group increased progressively from preoperative to postoperative values continued and to increase. In the distraction rod group the postoperative kyphosis was improved compared with the preoperative values. At final follow-up the kyphosis had returned nearly to the preoperative values. The difference in the adequacy of the reduction as measured by percentage of anterior collapse between the two groups is highly statistically significant: distraction rod better postoperatively, P = 0.0114 (Student's t-test); distraction rod better at final follow-up, P = 0.0054 (Student's t-test).