Reduction and stabilization of lumbar and thoracolumbar spine fractures with Louis' plates and internal fixator: a comparative study.

In this retrospective study, 28 patients who presented isolated fractures from T11 to L4 were surgically treated using a posterior approach. The fractures were reduced and stabilized in half of the cases with Louis' plates and in the other half with an internal fixator. Twelve patients had partial neurological deficits on admission. They were reviewed after a mean period of 24 months from time of injury, and 10 months after implant removal. The kyphosis of the fractured vertebral body was measured, and showed a mean value of 18 degrees before surgery and 10.3 degrees at the last visit. The regional statics of the spine were also studied. The residual mobility of the fixated and neighbouring spinal units was assessed, comparing "long" segment fixation (plates) with "sh ort" segment fixation (internal fixator). The residual mobility of the adjacent, non-fixed segments was significantly better when the internal fixator had been used than with the Louis' plates. Of the 12 patients with neurological involvement, 11 had increased their Frankel score by one grade. Results were evaluated by clinical parameters (pain, neurological deficit, occupational disability); scores were as follows: 32% good, 57% satisfactory and 11% poor. There was no significant difference in clinical score between the two treatment modalities.