Double approach in thoraco-lumbar malunions.

Thoracolumbar fractures (T11-L2) complicated by malunion often need surgery. In our hands two approaches are necessary for release and fusion. Correction is obtained by posterior bending in situ of a screw rod fixation. When the deformity is flexible, first we perform a posterior reduction and stabilization, and secondly an anterior approach for interbody fusion. When spine is rigid an anterior release with waiting bone graft is performed first followed by a second posterior reduction and stabilization. This strategy allows a real correction without the loss of correction in time. This technique is fast and safe as demonstrated in our series of 20 patients.