Unstable thoracolumbar and lumbar burst fractures treated with the AO fixateur interne

J Spinal Disord. 1992 Sep;5(3):335-43. doi: 10.1097/00002517-199209000-00012.


Twenty-five consecutive patients with unstable thoracolumbar and lumbar burst fractures were surgically treated with the AO Fixateur Interne (Synthes USA, 1690 Russell Rd., Paoli, PA). Indications for surgery included a progressive neurologic deficit, spinal canal compromise greater than 50%, vertebral body collapse greater than 50%, or sagittal angulation greater than 20 degrees. Twenty males and five females ranging in age from 16 to 60 years (average 31) were treated surgically and prospectively followed. Twenty-one fractures occurred at the thoracolumbar junction (T10-L2) and 4 in the lumbar spine (L3-5). Twenty-four patients were followed for a minimum of 12 months, ranging from 12 to 38 months (average 22); one patient was lost to follow-up after 1 month postoperatively. Preoperatively, 12 patients had partial neurologic deficits; postoperatively, 11 improved at least 1 Frankel grade. Preoperatively, the 12 patients with partial neurologic deficits averaged 45 points (range 24-49) on the lower extremity motor index scale. After surgery, these patients improved an average of five points (range 1-23) on the motor index scale. Both patients with complete spinal cord injuries remained unchanged neurologically postoperatively; no patients deteriorated neurologically after surgery. The average preoperative sagittal kyphosis at the fracture site was +16 degrees (range +10 degrees to +31 degrees); the immediate postoperative sagittal angular correction averaged -4 degrees (lordosis) and ranged from +12 degrees (kyphosis) to -26 degrees (lordosis). At last follow-up, the sagittal angular correction remained unchanged in three patients and decreased in 21 patients to an average of +5 degrees (range +37 degrees to -14 degrees).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bone Screws
  • Equipment Failure
  • Female
  • Follow-Up Studies
  • Humans
  • Internal Fixators*
  • Joint Instability / diagnostic imaging
  • Joint Instability / surgery*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Paralysis / etiology
  • Paralysis / surgery
  • Prospective Studies
  • Spinal Fractures / complications
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery*
  • Spinal Fusion / methods*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery*
  • Tomography, X-Ray Computed