[Stabilization of 150 unstable spinal injuries with the Cotrel-Dubousset instrument--analysis of results]

The present study is a retrospective analysis of spinal fracture treatment with the Cotrel-Dubousset instrumentation technique. 150 unstable injuries of the spine were treated with the CD implant at the University of Louisville--Level I Trauma Center--between February 1985 and March 1989. There were 67 burst fractures, 48 compression fractures and 21 fracture dislocations, 8 flexion distraction fractures and 6 flexion rotation injuries. Ninety-three patients underwent anterior cord decompression and strut grafting followed by posterior CD instrumentation and posterolateral fusion. Fifty-seven patients had posterior CD instrumentation and fusion alone. No neurological deterioration after the procedure was observed, 33 patients improved neurologically. Hospital stay ranged between 7 and 60 days (mean 20 days). 114 patients had a minimum follow up of 6 months (range 6-52 months). The mean follow up was 17.7 months. At final follow up 77.8% of the patients had returned to work and 84.2% of the patients were almost painfree. The mean loss of correction in the sagittal plane was 6.2 degrees (range: 0 and 42 degrees) at final follow up. As technical complications there were four hook cut outs (2.6%) of which two underwent reosteosynthesis and two did not effect the clinical or radiographic result. The high stability of the device provides a decreased risk of neurological deterioration, a decreased risk of posttraumatic kyphosis and early rehabilitation.