Use of Long Rods and a Short Arthrodesis for Burst Fractures of the Thoracolumbar Spine. A Long-Term Follow-up Study

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Abstract

Thirteen patients who had a burst fracture of the thoracolumbar spine (the twelfth thoracic to the fifth lumbar vertebra) were managed with the use of long rods and a short arthrodesis (the so-called rod-long, fuse-short technique). The patients were followed for an average of seventy-four months (range, thirty-four to 118 months).

Six months after the operation, the rods were removed and the fusion mass was explored.At that time, twelve patients had a solid fusion at all levels of the arthrodesis. Of the eighty-eight facet joints that had been spanned by the rods but had not been included in the arthrodesis, two had nevertheless progressed to fusion, as determined radiographically. Physiological motion was present in forty-three of the forty-four segments for which a fusion had not been intended.

Before the operation, the average anterior height of the fractured vertebrae was 61 per cent of the estimated height before the injury; this improved after the operation to an average of 83 per cent (median, 87 per cent) of the height before the injury.At the latest follow-up examination, the anterior height was an average of 78 per cent of the estimated height before the injury (median, 82 per cent; range, 51 to 93 per cent), a slight decrease compared with the value immediately after the operation.

Kyphosis of the injured segment before the operation, measured for twelve of the thirteen patients, averaged 15 degrees (median, 12 degrees; range, 0 to 33 degrees); as a result of the operation, this improved an average of 15 degrees, to 0 degrees of kyphosis.At the latest evaluation, the average kyphosis of the injured segment was 9 degrees (median, 10 degrees; range, -11 to 23 degrees). Nine patients lost more than 7 degrees of the initial correction.

Residual back pain was absent or mild in ten patients and moderate in three.Eleven patients had returned to the pre-injury level of employment or active retirement, or they were working full-time at a different job, indicating a satisfactory functional outcome in this series.

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