Clinical biomechanics of spinal fixation-anterior, posterior, and lateral

The three primary systems of spinal fracture-fixation may be categorized as follows: (a) Posterior fixation of the fractured spine by means of devices attached to posterior structures of the spinal column. These devices apply flexion-resisting forces to the deformed spinal column but cannot correct the spinal deformity nor decompress the spinal cord; (b) Lateral fixation of the fractured spine by means of devices that are attached parallel to the intact vertebral bodies above and below the fractured body, and bypass the loading on the spine across its fractured segment; (c) Anterior fixation of the fractured spine by means of a device that replaces the fractured vertebral body segment and transmits the load through it from the intact vertebral body above the fractured body to the intact spinal fracture below it. Here the authors provide biomechanical analyses of the function and efficacy of each of these systems, supported by some case histories.<>