Total vertebrectomy and spine shortening in the management of acute thoracic spine fracture dislocation: technical note and report of 3 cases.

STUDY DESIGN Case report of 3 thoracic spine fracture-dislocations with complete spinal cord section treated by total vertebrectomy--spine shortening through a posterior approach. OBJECTIVES To assess the usefulness and safety of this surgical technique in the treatment of acute thoracic spine fracture-dislocation. SUMMARY OF BACKGROUND Total vertebrectomy can be used in different nontraumatic disorders. This surgical procedure has been used in the chronic phase of traumatic thoracolumbar dislocation. To our knowledge, the technique of total vertebrectomy and spine shortening in the acute phase of thoracic spine fracture dislocation has never been reported. MATERIAL AND METHODS Three patients who suffered thoracic spine fracture-dislocation with ASIA A paraplegia underwent complete vertebrectomy and spine shortening through a posterior approach. We report technical details, clinical, and radiologic results at 24 months minimum follow-up. RESULTS Complete vertebrectomy of the fractured vertebra involved T5 in 1 patient, T7 in another, and T10 in the third. There were no perioperative complications. At latest follow-up, fusion was obtained in all 3. Overall sagittal and coronal alignment was restored. CONCLUSIONS Complete vertebrectomy and spinal shortening can be used in the acute phase to manage thoracic spine fracture-dislocations.