Operative treatment of unstable thoracolumbar fractures by the posterior approach with the use of Williams plates or Harrington rods.

Two similar groups of patients with unstable fractures and fracture dislocations of the thoracic or lumbar spine have been treated with the posterior application of Williams plates or Harrington distraction rods over a period of 10 years. The instrumentation was routinely removed from 13 to 19 months after insertion. The initial preoperative kyphotic angle was corrected by a mean of 4.5 and 6.9 degrees respectively. However, follow up after a minimum of four years has shown a loss of correction by a mean of 14.4 and 12.7 degrees to an angle of 21.9 degrees even in the Harrington rod cases. These results do not show the ability to maintain correction of deformity by either method with a dorsal approach. Reduction and stabilization of fractures of the spine should be directed to the anterior part of the vertebrae to overcome late deformity of the spine.