Surgical treatment of fractures of the thoracic and lumbar spine via the transpedicular route.

Sixty-seven consecutive patients with burst or dislocation fractures of the thoracic or lumbar spine were submitted to early surgical reduction, via the transpedicular route, over a 5-year period. The first 22 patients received Harrington instrumentation, while transpedicular devices were applied in the last 44 cases, at either the thoracic or the lumbar level. One patient did not receive any spinal instrumentation. This surgical approach was found to be reliable in achieving a near-anatomical reconstruction of the fractured spinal segment. The rate of post-operative complications was low. Placement of transpedicular devices proved to be a safe and effective procedure. The overall results were consistent with the thesis that the transpedicular approach compares favourably with alternative surgical methods.