Abstract
A new system of operative fixation of thoracolumbar and lumbar spine fractures is presented: the cfixateur interne' (F.I.). From a posterior approach long Schanz screws are inserted through the pedicles into the body of the two vertebrae just adjacent to the lesion and connected by the threaded F.I. rods. By tightening the nuts the Schanz screws are fixed in all directions. The advantages of the F.I. system are: excellent reposition by the long lever-arm of the Schanz screws, immobilization of only two segments and therefore good mobility of the residual spine, stability against flexion forces better than is obtained with Harrington distraction rods, additional rotational stability, and fixation in lordosis or kyphosis as is desired.
The F.I. does not act as a four point bending system like all other dorsal spine instrumentation systems, but provides stability in flexion by itself. Therefore it can be used independently of the condition of all ligaments (including the anterior longitudinal ligament) and of the posterior wall of the fractured vertebrae, and there is no need to fix more than the two immediately adjacent vertebrae, thus avoiding the often painful and cumbersome iatrogenic loss of lumbar lordosis and of mobility and permitting early mobilization of the patient. Experience with the first 45 patients is very promising.
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Bedbrook G M 1979 Spinal injuries with tetraplegia and paraplegia. Journal of Bone and Joint Surgery 61B:267–284
Convery F R, Minteer M A, Smith R W, Emerson S M 1978 Fracture-dislocation of the dorsolumbar spine. Acute operative stabilization by Harrington instrumentation. Spine 3:160–166
Daniaux H 1982 Technik und erste Ergebnisse der transpedikulären Spongiosaplastik bei Kompressionsbrüchen im Lendenwirbelsäulenbereich. Acta Chirurgica Austriaca, Supplement 43:79
Dick W 1984 Innere Fixation von Brust- und Lendenwirbelbrüchen. Bern-Stuttgart-Wien: Hans Huber.
Dickson J H, Harrington P R, Erwin W D 1978 Results of reduction and stabilization of the severely fractured thoracic and lumbar spine. Journal of Bone and Joint Surgery 60A:799–805
Flesh J R, Leider L L, Erickson D L, Chou, S N, Bradford D S 1977 Harrington instrumentation and spine fusion for unstable fractures and fracture-dislocations of the thoracic and lumbar spine. Journal of Bone and Joint Surgery 59A: 143–153.
Frankel H L, Hancock D O, Hyslop G, Melzak, J, Michaelis L S, Ungar G H, Vernon, J D S, Walsh J J 1969 The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Paraplegia 7:179–192
Gertzbein S D, Macmichael D, Tile M . 1982 Harrington instrumentation as a method of fixation in fractures of the spine. A critical analysis of deficiencies. Journal of Bone and Joint Surgery 64B:526–529
Hasday C A, Passoff T L, Perry J 1983 Gate abnormalities arising from iatrogenic loss of lumbar lordosis secondary to Harrington instrumentation in lumbar fractures. Spine 8:501–511
Holm S T, Nachemson A 1982 Nutritional changes in the canine intervertebral disc after spinal fusion. Clinical Orthopaedics 169:243–258
Jacobs R R, Dahners L E, Gertzbein S, Nordwall A, Mathys, R 1983 A locking hook—spinal rod: current status of development. Paraplegia 21:197–207
Jacobs R R, Nordwall A, Nachemson A L 1982 Reduction, stability, and strength provided by internal fixation systems for thoracolumbar spinal injuries. Clinical Orthopaedics 171:300–308
Osebold W R, Weinstein S L, Sprague B L 1981 Thoracolumbar spine fractures: results of treatment. Spine 6: 13–34
Purcell G A, Markolf K L, Dawson E G 1981 Twelfth thoracic—first lumbar vertebral mechanical stability of fractures after Harrington rod instrumentation. Journal of Bone and Joint Surgery 63A:71–78
Stauffer E S, Neil J L 1975 Biomechanical analysis of structural stability of internal fixation in fractures of the thoracolumbar spine. Clinical Orthopaedics 112:159–164
White A A, Panjabi, M M, Thomas C L 1977 The clinical biomechanics of kyphotic deformities. Clinical Orthopaedics 128:8–17
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This paper was read at the Annual Scientific Meeting of the International Medical Society of Paraplegia in Denver, Colorado, U.S.A., June, 1984.
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Dick, W., Kluger, P., Magerl, F. et al. A new device for internal fixation of thoracolumbar and lumbar spine fractures: the ‘fixateur interne’. Spinal Cord 23, 225–232 (1985). https://doi.org/10.1038/sc.1985.38
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DOI: https://doi.org/10.1038/sc.1985.38
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