The Journal of Bone and Joint Surgery, Vol 76, Issue 11 1629-1635, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Use of long rods and a short arthrodesis for burst fractures of the thoracolumbar spine. A long-term follow-up study
BA Akbarnia, DG Crandall, K Burkus and T Matthews
St. Louis University Medical Center, Missouri.
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.(ABSTRACT
TRUNCATED AT 250 WORDS)