Abstract
To minimize the numbers of vertebral segments in the fusion area and to prevent the metal failure and recurrence of deformity in the surgical treatment of the fracture and dislocations of the thoracic and lumbar vertebra, short segment transpedicular C-D instrumentation including upper and lower adjacent vertebra and also the involved vertebra had been performed in 56 patients, from 1989 to 1991 and the minimum follow-up period was one years. Fractured vertebra was screwed for the reposition of the compressed upper end plate and its maintainance. The purpose of this study is to report the satisfactory results the procedure in stability and deformity correction. The mechanisms of injuries were fracture-dislocation in 17, compression in 10, burst in 8 and seat belt in 8. Levels of the lesion were between T10 and L4. Extent of fusion was one to 4 motion segments(Av. 2. 1 segments). Ambulation was started Av. 3.8. days after operation. External support of TLSO was applied for 3 months. Complications of metal failure, loss of fixation and the recurrence of the kyphotic deformity were not occurred during follow up period. Anterior vertebral height in average compared to normal vertebra were 69% preoperatively, 89% post operatively and 85% at the end of follow up. Angle of kyphotic deformity in average were 25 preoperatively, 8 post-operatively and 11 at the end of follow up. From the above results, the authors concluded that the short segment transpedicular C-D instrumentation including involved vertebra is a highly successful method of treatment with good correction of deformity and rigid stability, while the operation could be confined in minimum extent.