Use of the Texas Scottish Rite Hospital instrumentation in the treatment of thoracolumbar injuries

Abstract

Study design: This is a prospective study of the results of the use of Texas Scottish Rite Hospital instrumentation for thoracolumbar and lumbar injuries. To make an objective assessment of the clinical and radiologic results, the second and the third authors were used as unbiased assessors.

Objectives: To evaluate the short-term results of the use of Texas Scottish Rite Hospital instrumentation in thoracolumbar injuries.

Summary of background data: To the authors' knowledge, there are only a few reports concerning the use of the Texas Scottish Rite Hospital instrumentation for stabilization of the spine, mostly in scoliosis and degenerative spine disease, and only one report on use of this instrumentation in thoracolumbar injuries.

Methods: Forty patients, with an average age of 45 years, who suffered from 48 thoracolumbar spinal fractures and dislocations, underwent posterior Texas Scottish Rite Hospital hook-rod instrumentation by means of "double-claw" configuration, two levels above and two below the lesion level for reduction of the injury, and stabilization and restoration of the sagittal profile of the thoracolumbar spine. Roentgenograms and computed tomography scans were evaluated on the basis of the same protocol before and after surgery and in follow-up observation.

Results: All patients were followed for an average period of 32 months. The sagittal profile of the thoracolumbar spine was restored significantly. No patient had neurologic deterioration after surgery, and all patients with incomplete lesions improved postoperatively at least one Frankel grade. One hook dislodgment was observed in one patient without loss of correction or non-union. There was only one deep infection.

Conclusions: With the Texas Scottish Rite Hospital instrumentation, it was possible to provide solid internal fixation with restoration of the sagittal profile without loss of correction.