Posterior spinal fusion using internal fixation with the Daab plate.

The results of posterior spinal fusion, supplemented by internal fixation with the Daab plate in 43 patients, are presented. The Daab plate is a quadruped implant placed longitudinally in the coronal plane and fixed by simply pinching it around the spinous processes. The cause of the instability necessitating fusion was acute trauma in eight patients, late posttraumatic condition in 11, pure degenerative process in seven and spondylolisthesis in nine patients. In addition, there were solitary cases of tuberculous spondylitis, pyogenic spondylitis and metastatic destruction of the vertebral body. The fusion site was cervical in three, thoracic in eight, thoracolumbar in 12 and lumbar or lumbosacral in 20 cases. The mean follow-up time was 19 months. The consolidation of the fused area could, apart from radiographs, ultimately be evaluated at removal of the implant in 39 patients. The fusion was successful in 37 patients. Compared with previous reports, this result must be considered satisfactory when the severity of the cases in this series is noted. Internal fixation in connection with posterior fusion is needed only exceptionally, but in complicated cases the Daab plate seems to afford a simple method of securing the position of the segments for the first postoperative months.