The Journal of Bone and Joint Surgery, Vol 75, Issue 2 168-176, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
Spinal mobility and deformity after Harrington rod stabilization and limited arthrodesis of thoracolumbar fractures
MB Dekutoski, ES Conlan and GG Salciccioli
Southeastern Michigan Regional Spinal Cord Rehabilitation Center, Detroit Receiving Hospital.
The results were reviewed for thirty patients in whom a thoracolumbar
fracture had been treated with a Harrington rod placed three segments
cephalad and two or three segments caudad to the injured vertebra and a
short arthrodesis with removal of the Harrington rod after at least twelve
months. The patients were evaluated with clinical examinations, lateral
radiographs made with the spine in flexion and extension, and
questionnaires at a median of thirty-two months after the stabilization.
All of the arthrodeses were successful. The twenty patients who had a burst
or compression fracture and who had posterior instrumentation lost only an
average of 9 degrees of sagittal correction before attaining a solid
fusion. For all thirty patients, the average motion in the sagittal plane
at the vertebrae that had been spanned by the Harrington rod but not
included in the arthrodesis ranged from 9 degrees at the third and fourth
lumbar level to 2 degrees at the eighth and ninth thoracic level. The
average total motion between five vertebrae that had been spanned by the
rod but did not have an arthrodesis was 24 degrees; between four vertebrae,
23 degrees; and between three vertebrae, 19 degrees. In this series of
thoracolumbar fractures treated with a longer Harrington rod than needed to
span the level of the arthrodesis and a short arthrodesis, there was a
documented return of motion to segments that had been previously spanned by
the instrumentation but not included in the arthrodesis and good or
excellent functional results over-all.
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