Anterolateral dynamized instrumentation and fusion for unstable thoracolumbar and lumbar burst fractures

Study Design. A retrospective chart review of 36 patients treated with dynamized anterolateral instrumentation and fusion after decompression for thoracolumbar and lumbar burst fractures is presented. Objectives. To evaluate a device that allows continual bone graft vertebral endplate compression and determine its potential for healing in patients with thoracolumbar and lumbar burst fractures. Summary of Background Data. Anterior spinal surgery has led to implant adaptations. Such implants have undergone an evolution in hopes of improving the rate of healing and avoiding neurovascular catastrophes. Methods. Thirty-six patients underwent anterior decompression dynamized instrumentation and fusion for thoracolumbar and lumbar burst fractures. This involved a dual-rod, quadrilateral, cross-linked frame that allows for continual compression but deters rotation and shear stresses. Results. All patients healed solidly without instrumentation failure. An average recovery of 1.3 Frankel grades was recorded. Subsidence of bone graft vertebral endplate was less than in those placed in a trough. Conclusions. Dynamized load-sharing anterolateral Cotrel-Dubousset instrumentation led to solid bone graft healing without implant failure by allowing continual compression while deterring shear and rotational stresses.