Commentary: Posterior tension band wiring and instrumentation for thoracolumbar flexion-distraction injuries.

Abstract

Tension band wiring has been used to re-appose bone fragments, secure ligaments or tendon to bone, and improve stability in weakened constructs. 1–5 The spinous ligaments, ligamentum flavum, facet capsular ligament, and posterior longitudinal ligaments collectively form the natural posterior spinal tension band. The integrity of the posterior spinal ligamentous structures is critical, as they function to limit translation (anterior and posterior), flexion, and rotation of the spine. Flexiondistraction injuries (FDIs) lead to posterior disruption and elongation, and hyperextension with or without shear causing anterior disruption and elongation. 6 Proper evaluation of the posterior elements is important for the diagnosis of FDIs. Magnetic resonance imaging has high diagnostic accuracy and inter-observer reliability. 7 Reconstruction of the posterior tension band combined with spinal instrumentation for FDIs improves stability and aids early rehabilitation. 8 Cables, wires, and other strands have been used to re-establish posterior tension band stability. 9–13 In this issue, Hasankhani and Omidi-Kashani 8