Thoracolumbar spine stabilization in fracture--dislocations

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Spinal Trauma Management

Background:

• Unstable spinal fractures, including fracture dislocations, pose significant challenges in treatment.
• Neurologic deficits, ranging from partial impairment to complete paraplegia, often accompany these injuries.
• Effective spinal stabilization is crucial for restoring canal integrity and improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of dorsal spinal stabilization using plates and screws for unstable fractures.
• To assess the outcomes in patients with and without neurologic deficits, including complete paraplegia.
• To determine the effectiveness of the Meurig-Williams plate system in achieving spinal stability and neurologic recovery.

Main Methods:

• Analysis of a series of 35 patients with unstable spinal fractures and fracture dislocations.
• Surgical intervention involving spinal stabilization with plates and screws.
• Specific focus on dorsal stabilization using Meurig-Williams plates for non-complicated fractures.
• Assessment of neurologic recovery in patients with pre-existing deficits.

Main Results:

• Very good results were achieved in 19 out of 35 patients with non-complicated fractures.
• Complete recovery of neurologic deficit occurred in five of 13 patients with initial neurologic deficits.
• Two paraplegic patients experienced complete neurologic recovery following the procedure.
• Dorsal stabilization combined with dorsal vertebrodesis and post-operative immobilization yielded a reliable posterior bone block.

Conclusions:

• Dorsal stabilization using Meurig-Williams plates is a reliable method for treating unstable spinal fractures.
• The surgical approach can lead to significant neurologic recovery, even in severe cases like paraplegia.
• This technique effectively restores spinal canal integrity and provides a stable posterior bone block.