The fixateur interne in the reduction and stabilization of thoracolumbar spine fractures in patients with neurologic deficit

A prospective analysis of 80 consecutive patients who underwent stabilization with the fixateur interne for tho-racolumbar spine fractures with complete or incomplete paraplegia was undertaken to determine the results after bone healing. Follow-up examination at an average of 35 months (minimum, 24 months) included all 76 patients still alive. One patient died from a pulmonary embolism, and there were three other unrelated deaths. The mean wedge angle of the fractured vertebra was corrected from 17.4° to 7.9° and remained almost unchanged after 1 year (8.4°) and 2 years, or 1 year after implant removal (8.2°). Also, the wedge index showed nearly no bony loss of correction within the reduced fracture vertebra (0.61 before operation, 0.83 after operation; 0.81 at 1-year follow- up, 0.81 at 2-year follow-up, respectively). In the kyphosis angle measured by the Cobb method, however, there was a loss of 5° after implant removal within the next year because of the disc space collapsed above the fractured vertebra. In this series, 70% of the cases had no formal fusion. All 29 cases of translational displacement of 4-36 mm were anatomically reduced. No neurologic or vascular complication occurred. Posterolateral fusion or trans- pedicular interbody fusion in the disrupted disc space is recommended.