Management of XXXX of the thoracolumbar and lumbar spite.

@entity1 @entity3510 @entity174 @entity51 @entity1274 @entity717 @entity893 @entity130
Eleven cases of @entity174 or @entity174 /dislocation of the thoracolumbar or lumbar spine were studied to determine the effectiveness of three methods of management of the @entity130 . Ten of the @entity1 had a @entity51 as well as a @entity3510 . All cases were studied by computed tomographic (CT) scanning of the injury site before and after treatment. CT scanning was found to be superior to linear tomography in determining the degree of canal compromise by bone at the injury site. Eight @entity1 underwent operation, with the aims of achieving spinal stability in unstable @entity130 and of decompressing @entity1274 . These 8 @entity1 had received Harrington distraction instrumentation (HDI) as an initial procedure. In those @entity1 with @entity174 /dislocations from @entity717 and canal compromise resulting from @entity893 , reduction of the @entity174 /dislocation by HDI resulted in stabilization of the spine and increase of the open canal area at the injury site. However, in those @entity1 with canal compromise resulting from bursting @entity174 with retropulsed bone fragments, HDI did not reduce in bone fragments. Removal of the anterior vertebral body and the bone fragments, however, did result in significant improvement of the canal dimensions. A poor correlation was found between the degree of canal compromise as measured by the CT scanner and the resulting @entity51 . Reasons for this are presented. Six of the 10 neurologically compromised @entity1 , including 2 @entity1 with stable bursting @entity130 and retropulsed bone fragments treated conservatively, had improved one grade on Frankel's classification by 3 months after injury. The rate and degree of recovery were not related to the degree of canal decompression achieved at operation.
