A comparison study of treatment of thoracolumbar fractures using the ACE Posterior Segmental Fixator and Cotrel-Dubousset instrumentation.

Abstract

The results of 26 consecutive thoracolumbar fractures treated with Cotrel-Dubousset instrumentation (CDI) (n = 12) or the ACE Posterior Segmental Fixator (n = 14) with a mean follow up of 20.2 months were analyzed. Preoperatively, no statistically significant difference was noted between the two treatment groups. Postoperatively, no statistically significant difference was noted for improvement of kyphosis (mean: -6.00 degrees ACE, 1.92 degrees CDI), vertebral body height (mean: 17.86% ACE, 18.83% CDI), vertebral body angle (mean: -6.21 degrees ACE, -5.42 degrees CDI), or estimated blood loss (mean: 1544 cc ACE, 1620 cc CDI). All patients with incomplete paraplegia improved by at least one Frankel grade. Statistically significant differences were noted in operative time (mean: 269 minutes ACE, 357 minutes CDI, P < .0005), and in the number of instrumented levels (mean: 3 ACE, 5.8 CDI). All patients exhibited solid fusion radiographically. Thoracolumbar fractures can be effectively treated by either CDI or the ACE Fixator. The ACE Fixator has the advantage of sparing motion segments and decreased operative time.