Surgical outcome of thoracolumbar burst fractures with flexion-distraction injury of the posterior elements.

Between 1991 and 2002 we treated 48 patients surgically for thoracolumbar burst fractures associated with flexion-distraction injury of the posterior elements. The degree of kyphotic deformity and the degree of vertebral wedging deformity were measured on plain lateral radiographs. The spinal canal compromise was measured on computer tomography. The mean postoperative follow-up was 70 (24-108) months. The preoperative kyphosis averaged 25.7 degrees and the mean sagittal index was 28.8 degrees . The mean wedging deformity of the fractured vertebral body was 46% (24-66%). The mean preoperative spinal canal compromise secondary to retropulsed bony fragments was 64%. Immediately after surgery, the correction of kyphosis averaged 98%. There was no loss of correction at the final follow-up. A satisfactory reduction and good stabilisation with solid fusion were achieved in all cases.