¿Qué aporta la artrodesis en la estabilización de las fracturas de la transición toracolumbar?

A retrospective study has been made on 26 patients with type II burst Denis fracture (23 cases) and type IV Denis fracture-dislocation (3 cases) of the thoracolumbar transition (T11-L2). Treatment consisted on a reduction and a stabilisation with a single transpedicular fixation (16 cases) or associated to a posterolateral arthrodesis (10 cases). The 84,6% of the patients carry out a normal life without pain or with slight problems which do not limit daily activity. The segmental traumatic average angle of kyphosis improved from 19,4 ± 7,8º to 8,7 ± 11,8º (p < 0,001). When comparing the final segmental traumatic average angle of kyphosis of the group of patients with arthrodesis (3,8 ± 6,9º) to the group without arthrodesis (7,8 ± 8,7º), the differences were not significant. The 6 patients who presented a marked loss of correction during the post-operative time, with breakage of material in 5 of them, belonged to the group without arthrodesis, and 4 of them had a laminectomy performed. The posterolateral arthrodesis associated to the stabilisation in burst thoracolumbar transition fractures did not improve the final kyphotic deformity significantly. The failures of material which brought on a marked loss of previous correction were related significantly to laminectomy without arthrodesis.