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23 Gaebler C, Maier R, Kutscha-Lissberg F, et al.: Results of spinal cord decompression and thoracolumbar pedicle stabilisation in relation to the time of operation. Spinal Cord 1999, 37:33-39. Patients with thoracolumbar burst fractures were treated with short-segment posterior instrumentation, transpedicular disc resection and cancellous bone grafting. Patients treated within 8 hours had significantly higher rates of neurologic recovery than those patients treated later. All patients with incomplete neurologic lesions who were operated on within 48 hours improved at least 1 Frankel grade. After 48 hours, there was no significant difference in the neurologic outcome compared with the time of operation. There was no significant difference in the extent of neurologic recovery with respect to the level of neurologic injury (spinal cord, conus, or cauda equina).
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25 Katonis PG, Kontakis GM, Loupasis GA, et al.: Treatment of unstable thoracolumbar and lumbar spine injuries using Cotrel-Dubousset instrumentation. Spine 1999, 24(22):2352-2357. The authors retrospectively studied patients with unstable thoracolumbar fractures treated with posterior indirect reduction and instrumented fusion. Patients with greater than 30 degrees of kyphosis and canal compromise greater than 50% were treated with combined anterior and posterior surgery and were excluded. Injuries from T11 to L2 were treated with postural reduction and posterior spinal fusion (PSF) two levels above and one level below the injured vertebrae. Injuries at L3-L4 were treated with postural reduction and PSF one level above and one level below the injury. Patients with complete disruption of the posterior longitudinal ligament underwent posterolateral decompression. All patients with incomplete neurologic injuries improved at least 1 Frankel grade. All patients progressed to solid fusion despite four instrumentation failures, none of which required reoperation.
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