Cotrel-Dubousset instrumentation in the treatment of unstable thoracic and lumbar spine fractures.

The use of computed tomography and developments in spinal biomechanics have led to a better understanding of vertebral fractures. The disappointing results achieved with conservative treatment have led to an increasing popularity of surgical treatment in the last 15 years. The results of 20 unstable thoracic or lumbar spine fractures treated surgically with Cotrel-Dubousset instrumentation at the First Clinic of Orthopaedics and Traumatology of the Ankara Social Security Hospital between December 1988 and June 1991 were evaluated in this study. The mean follow-up was 31.9 months. The mean sagittal index angle was 23.7 degrees +/- 6.8 degrees preoperatively and was corrected by 67.1 +/- 29.9%, and the thoracolumbar junction angle was brought within physiological limits in 65% of the cases. Postoperatively, the neurological status improved in 15% of the patients and remained unchanged in the rest. It was concluded that the Cotrel-Dubousset instrumentation established vertebral stability in unstable vertebral fractures by forming a rigid frame and restored physiological thoracic and lumbar postural contours due to its highly corrective effect in the sagittal plane.