Abstract
A review of 14 patients treated for spinal fracture using lumbar pedicle screw and thoracic pediculotransverse claw "hybrid" Cotrel-Dubousset fixation was performed. Pedicle screw fixation was used one level below the most inferiorly injured vertebrae. Pediculotransverse claw constructs were used for thoracic level fixation three segments above the superior injured vertebrae. Fractures were classified as burst (n = 9), burst dislocation (n = 3), and thoracic facet dislocation (n = 2). Complications included one patient who increased his kyphosis postoperatively before stabilizing at 3 months and one patient with a single screw breakage noted at 1 year. Both patients are asymptomatic. Early results demonstrate that this hybrid pedicle screw and pediculotransverse claw fixation is a satisfactory alternative to other posterior distraction methods. The use of the claw fixation superiorly allows for safe instrumentation in the thoracic spine, where pedicle screw placement is hazardous or may not be possible due to the small pedicle diameter.
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