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Anterolateral dynamized instrumentation and fusion for unstable thoracolumbar and lumbar burst fractures
A L Carl1, B I Tranmer, B L Sachs
1Division of Orthopaedic Surgery, Albany Medical College, New York, USA.
Study Design:
A retrospective chart review of 36 patients treated with dynamized anterolateral instrumentation and fusion after decompression for thoracolumbar and lumbar burst fractures is presented.
Objectives:
To evaluate a device that allows continual bone graft vertebral endplate compression and determine its potential for healing in patients with thoracolumbar and lumbar burst fractures.
Summary Of Background Data:
Anterior spinal surgery has led to implant adaptations. Such implants have undergone an evolution in hopes of improving the rate of healing and avoiding neurovascular catastrophes.
Methods:
Thirty-six patients underwent anterior decompression dynamized instrumentation and fusion for thoracolumbar and lumbar burst fractures. This involved a dual-rod, quadrilateral, cross-linked frame that allows for continual compression but deters rotation and shear stresses.
Results:
All patients healed solidly without instrumentation failure. An average recovery of 1.3 Frankel grades was recorded. Subsidence of bone graft vertebral endplate was less than in those placed in a trough.
Conclusions:
Dynamized load-sharing anterolateral Cotrel-Dubousset instrumentation led to solid bone graft healing without implant failure by allowing continual compression while deterring shear and rotational stresses.