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AN ELEGANT TECHNIQUE FOR REDUCTION AND FIXATION OF COMPLEX VERTEBRAL FRACTURES



Abstract

Background: Complex Thoraco-Lumbar Spine fractures and fracture-dislocations are not common injuries and pose a great challenge for the surgeon. No method had been accepted as a gold standard for the treatment of such injuries. We describe our experience with the use of the Socon reduction system, which was originally designed for reduction of lumbar spondylolisthesis, for the treatment of complex Thoraco-lumbar injuries.

Materials and Methods: During the years 2000–2005 6 patients with AO type C Thoraco-lumbar injuries were operated using the Socon reduction system. 5 of them had complete paraplegia at the level of injury and one was neurologically intact. Reduction was achieved using the socon reduction system, and once in reduced position the fracture was stabilized using another posterior pedicular screws and rods system.

Results: Good sagittal and coronal alignment has been achieved in all 6 cases and stable fixation was achieved using posterior instrumentation. The Patient who didn’t have neurological deficits remained intact throughout the procedure. No major complication has been noted and reduction and fixation was stable during the follow up period with no case of hardware failure despite early mobilization.

Conclusions: The Socon reduction system provides an elegant and reliable mean for the reduction of complex Thoraco-lumbar spinal injuries. The system enables the reduction to be carried out only in a posterior approach thus minimizing the risks for further neurological insult and avoiding further damage to the facet joints. The use of posterior instrumentation proved safe and stable in this group of patients.

The abstracts were prepared by Orah Naor, IOA Co-ordinator and Secretary. Correspondence should be addressed to Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.