Safety and efficacy of spinal loop rectangle and sublaminar wires for osteoporotic vertebral compression fracture fixation

Use of Hartshill Rectangle with Sublaminar Wiring in Spinal Stabilization of D4-D5 Fracture Dislocation with Acute Spinal Cord Injury - A Cost-Effective Treatment

Introduction

Fractures in the upper thoracic spine pose technical challenges due to the transition from cervical to thoracic spine, often resulting in complete spinal cord injuries necessitating stabilization. Various posterior fixation techniques include Harrington rods, wired distraction rods, L-rods with sub-laminar wiring, and pedicle screw fixation. Luque pioneered sublaminar wiring (SLW), later enhanced by Dove's Hartshill system for superior biomechanical stability. This case underscores the efficacy of the Hartshill system in stabilizing upper thoracic fractures with severe cord injuries, offering a cost-effective alternative to pedicle screw fixation.

Case Report

A 30-year-old female with polytrauma presented symptoms of lower limb paralysis, bladder and bowel dysfunction, and loss of sensation. Imaging showed a severe D4-D5 fracture with retrolisthesis and spinal cord compression, necessitating surgical stabilization using a Hartshill rectangle with SLW. Following surgery, early rehabilitation and physical therapy were initiated, demonstrating the effectiveness of proper fixation in facilitating early mobilization.

Conclusion

The Hartshill rectangle, with SLW, offers enduring spinal stabilization for unstable thoracic fractures with spinal cord injuries, enabling early mobilization and reducing neurological risks. Its versatile application spans scoliosis corrections and trauma-related spinal stabilization, reflecting its widespread use in spinal surgery.