Anterior fixation for fractures of the thoracic and lumbar spine with or without neurologic involvement.

The anterior approach is useful for treatment of early and late thoracic and lumbar spine burst fractures but is especially useful for a post-traumatic kyphosis. The indications for dural decompression include acute neurologic injury in which CT scanning shows evidence of significant canal intrusion of the spinal cord. The use of anterior fixation devices (and, in particular, the anterior Kostuik-Harrington distraction device), supplemented with Dwyer screws and a solid Hall rod, precludes the necessity of any posterior approach. Anterior surgery has been performed in 49 cases for burst injuries of the thoracic and lumbar spine. Dural decompression was performed in 42 cases. A modified Kostuik-Harrington distraction with supplementary fixation was applied in 31 patients; there were no cases of nonunion or instrumentation failure.