Current trends in stabilizing high thoracic and thoracolumbar spinal fractures.

Studying treatment data for 1,385 patients with traumatic paraplegia registered with the National Spinal Cord Injury Data Research Center during 1973-1979, we investigated: (1) current treatment trends; (2) continuity or change in such trends; (3) trend implications; and (4) whether current practices reflect the controversy in the literature. The data showed little change in the proportion of patients treated surgically, but statistically significant changes in the procedures, especially as related to Harrington rod instrumentation, which increased dramatically both with bony fusion (from none to 24.4%) and in the triple procedure, which adds laminectomy (from 6.1% to 23.2%). These changes have clearly improved health care, as the two predominant surgical treatments were associated with the shortest hospital stays in both the acute and rehabilitation settings.