[The application of Dick instrumentation in the field of spine surgery]

From June, 1989 to March, 1991, 24 cases were treated in our department with the Dick technique. The study population included 7 patients with fresh horacolumber spine fracture, 10 with late spinal fracture (15 of the above 17 cases had incomplete paraplegia), 3 with ankylosing spondylitis, 2 with tuberculosis, and one each with spondylolisthesis and spine tumor. The results of these 24 cases were as follows. In the fresh fracture group, all the spine fractures were reduced completely. The 2 patients without neurological defects returned to work 3 months after operation. The 3 with incomplete paraplegia had rapid neurological recovery and could walk with a brace 3 months after surgical treatment. The 2 with complete paraplegia did not recover after toperation. In the late fracture group, traumatic kyphotic curve were reduced partially and back pain was decreased markedly in all 10 cases. Muscular power was increased significantly in 3 cases; they are all able to walk with a cane. Spasticity was remarkably improved in 2 patients after operation; they can now walk with crutches. Three patients obtained complete cure of incontinence. Four patients had no significant improvement. In the 3 patients with ankylosing spondylitis, the initial average kyphotic curve was 73.3 degrees, while the postoperative average curve was 28.3 degrees. The result in treating spinal stenosis due to degenerative spondylolisthesis was good: the slipping vertebrae were stabilized and fused with the Dick system after thorough decompression. In the tumor and Tb-spine cases, the patients recovered and were ambulatory soon after operation, thanks to rigid internal fixation.