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A series of 26 patients with severe thoracolumbar burst fracture was treated with Harrington instrumentation. Pitfalls and failures in adequate stabilization are presented. In 2 cases vertebral arch supporting the hook was damaged. These patients required restabilization combined with anterior fusion. In another case sublaminar wire loop pulled by the hook compressed the dural sac. Long rods (over more then five segments) were usually applied for stabilization of several arches damage, most often cranially from the fracture site or developmental defects within L5 and S1. The best stabilization with short rods has been achieved within lumbar spine or in cases supplemented with anterior fusion with the use of bone graft.
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