Complications in Instrumentation Surgery of Thoracolumbar Fractures

Various kinds of spinal instrumentation have been developed for treatment of spinal fractures associated with instability. This is a retrospective clinical and rentgenographic study to evaluate the effectiveness of the surgical treatment of spinal fracture and its' complications in each instrumentation. One hundred and sixty cases of thoracolumbar fractures treated with instrumentation from 1982 to 1991 were analysed. The results were as follows: 1) The cause of spinal fracture were 77 cases of falling injury(48.1%), 58 cases of traffic accident(36.3%) and 21 cases of blunt trauma(13.1%). 2) The most frequent fracture level was T12-L1 fracture and dislocation. 3) Harrington rod were most frequently used instrument in early 1980s, Luque rod in middle 1980s, Cotrel-Dubousset instrument and AO device in late 1980s. 4) The complications were observed in 23(14.4%) out of 160 cases, which were 14 cases(60.9%) of metalic failure and 5 cases(21.7%) of kyphosis, 2 cases(8.7%) of pain and 2 case(8.7%) of instability. 5) The complications according to each instrument were 6(23.1%) out of 26 cases in Harrington rod, 6(16.2%) out of 37 cases in Luque rod, 5(14.7%) out of 34 cases in Cotrel Dubousset instrument and 3(9.7%) out of 31 cases in AO device. On the basis of this study, short segment internal fixator such as Cotrel-Dubousset instrument and AO device are superior to Harrington and Luque rods when used as an internal fixator of spinal fracture.ope