Journal List > J Korean Orthop Assoc > v.28(1) > 1113765

Ha, You, and Lee: Treatment of Burst Fractures in Thoracolumbar Spine Using the C. A. S. F. Plate and Kaneda Device

Abstract

In the treatment of a burst fracture, devices serve to readily correct deformity, provide stability, and allow for early rehabilitation and ambulation. More recently, new devices have been developed for anterior fixation. The purpose of the present study is to compare cases treated by anterior decompression and instrumentation with either the Contoured Anterior Spinal Fixation (C.A.S.F.) Plate and the Kaneda Device. The subjects were 22 patients with burst fractures of the thoracolumbar spine. Twelve cases were treated with the C.A.S.F. Plate and 10 were treated with the Kaneda Device during the period of 1989 to 1990 and followed up on 16 to 38 months later with an average of 24 months. Among 15 cases with neurologic deficit, 10 out of 11 cases of incomplete neurologic dificit were improved to 1-2 on the Frankel scale, and 4 cases of complete neurologic deficit were not improved. In the correction of kyphotic deformity, the C.A.S.F. Plate showed 16.9 degrees and the Kaneda Device showed 16.3 degrees. In the loss of correction, the C.A.S.F. Plate showed 3.2 degrees and the Kaneda Device showed 2.5 degrees. In the height of the anterior column, the C.A.S.F. Plate showed improvement from preoperative 32.9% to postoperative 81.4% and the loss of correction was 2.8%. The Kaneda Device showed improvement from preoperative 50% to postoperative 89.496 and the loss of correction was 2.7%. Concerning complications, one case using C.A.S.F. Plate revealed loosening of distal 2 screws and one case using Kaneda device revealed breakage of distal screw and rod. In conclusion, there was no significant difference between the C.A.S.F. Plate and the Kaneda Device in the correction of kyphotic deformity, the reestablishment of the height of the anterior column, the operation time and the loss of blood during the operation. Anterior instrumentation with the C.A.S.F. Plate or the Kaneda Device after strut bone grafting can safely lead to a more rigid spinal segment and to early rehabilitation. However, careful long term follow up is required because of the possibility of metal failure and right lateral wedging.

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