Back pain after thoracolumbar fracture treated with long instrumentation and short fusion

The purposes of this retrospective study are to evaluate the degeneration of facets in unfused segments immobilized by Harrington rods and to see how often back pain developed after treatment with this method. Sixty patients with thoracolumbar fracture were treated with the Harrington rod long-fuse short technique. Harrington rods are removed an average of 14 months after initial surgery. Every case showed solid fusion during implant removal exploration. Thereafter, all cases were followed for a minimum of 5 years. Roentgenographic studies and a bone scan were performed to evaluate the degeneration of facet joints. Back pain complaint was found in 11 patients (18.3%). The degeneration of unfused facets was visualized in six patients by roentgenograms. Increased activity in the instrumented spine by bone scan examination also was noted in six patients: three cases were at unfused area, one at a fused area, and two at fused and unfused areas. In conclusion, degeneration in the immobilized and unfused segments after rod long and fused short was rarely seen clinically after long-term follow-up. Back pain was experienced in only 18.3% of the patients and seldom required medication.