Posterior instrumentation for spinal injuries and non-traumatic disorders. Report on surgical practice.

Abstract

Background: The purpose of the report is to show potential of the operative treatment with instrumentation for correction of traumatic and non-traumatic spinal deformities.

Methods: Between 2001 and 2005 total of 95 patients with spinal disorders were operated on, including 50 surgeries facilitated with posterior instrumentation. The age of the patients ranged from 2 to 66 years. Forty patients had neurological deficit. Transpedicular fixation (TPF) was used in 40, and wiring in 10 cases.

Results: Complete reduction of deformity was achieved in fracture dislocations, and adequate decompression in burst fractures via bilateral transpedicular or postero-lateral approach. Low back pain resolved completely in 5 of 7 patients with degenerative lumbar spine. Early complications were recorded in 11 cases.

Conclusion; TPF is the method of choice in fracture-dislocations and burst fractures of thoracic and lumbar spine. Superior reposition and rigid fixation can provide best conditions for rehabilitation of the patients with severe neurological deficit. Wiring is adequate in stabilizing cervical dislocations. Short internal fixation of lumbar spine spares healthy mobile segments in fusion of the degenerated vertebras. Every patient is to get differential approach depending on type, localization of the disorder and neurological status.