Dynamic Spine Alloplasty (Spring-loading Corrective Devices) After Fracture and Spinal Cord Injury

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Abstract
Guttman,3 7 who has probably had the most clinical material at the Stoke Mandeville Hospital, also analyzed the results achieved in patients treated surgically immediately after trauma, in particular by laminectomy with application of a variety of stabilizing systems. He expressed an authoritative opinion that surgical treatment should be discontinued, as he obtained almost perfect corrections by means of a slow redressing method, using to that effect appropriate progressing positioning; or else by means of the cervical skull traction technique. Unfortunately, the facilities now available to surgeons, and also to most of the rehabilitation centers, even those for the treatment of spinal cord injuries, cannot be compared with those at Stoke Mandeville; those perfect facilities can be found in only a few centers around the world. On the basis of clinical experience, Guttman's objections to surgical treatment can be interpreted as follows: (1) operation on an injured spine adds surgical shock to the traumatic one; (2) vascular pathology of spinal cord damage — particularly venostasis, swelling and thrombosis, demand a different approach to spine trauma than to other traumatic conditions. Regardless of these objections, which have to be fully accepted, we organized a research program on the application of dynamic stabilization of a fractured spine, based on the ideas introduced by Gruca for the treatment of scoliosis. The operation was modified to meet our needs, as regards the technique of setting up the springs, the construction of hooks, and methods to apply proper tension.

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