Comparison of Short Segment Pedicle Screw Fixation Including the Fractured Vertebra Versus Long Segment Fixation in Thoracolumbar Fractures
Journal Title: Journal of Academic Research in Medicine - Year 2020, Vol 10, Issue 1
Abstract
Objective: To compare the radiologic outcomes of short-segment fixation (SSF-P) with screw insertion into the fractured vertebra versus long-segment fixation (LSF), without fractured-level screw for the treatment of unstable thoracolumbar fractures. Methods: Radiological parameters of 17 patients who had SSF-P or LSF for the treatment of unstable thoracolumbar fractures and had at least one-year fallow-up duration were retrospectively evaluated. Local kyphosis (LK) angle and anterior vertebral height (AVH) value were measured from the preoperative, early postoperative and follow-up radiographs; intergroup comparisons were performed. Results: The mean age of the patients (male: 12, female: 5) was 50.1±12.8 years and the mean follow-up duration was 15.7±6.4 months. Fracture levels were L1 (n=8), L2 (n=5), T12 (n=2), L3 (n=1) and L4 (n=1). SSF-P was performed for 9 patients and LSF for 8 patients. The mean preoperative LK angles were 17.4±10.6° in the SSF-P group and 16.5±5.8° in the LSF group (p=0.83). In early postoperative measurements, the mean LK angles were 6.9±5.6° in the SSF-P group and 10.3±7.3° in the LSF group (p=0.14). In the follow-up evaluation, they were 8.8±5.8° and 12.0±7.2°, respectively (p=0.36). Preoperative mean AVH values were 72.4±14.5% in the SSF-P group and 56.4±14.8% in the LSF group (p=0.05). In early postoperative measurements, AVH values were 88.5±9.5% in the SSF-P group and 75.6±18.5% in the LSF group (p=0.13). In the follow-up evaluation, they were 86.6±11.3% and 69.1±19.5%, respectively (p=0.06). Conclusion: Radiological outcomes of SSF-P were similar to LSF in the treatment of unstable thoracolumbar burst fractures. We recommend the SSF-P method, which provides a stable fixation without sacrificing mobile segments, in the treatment of unstable burst fractures.
Authors and Affiliations
Engin Çetin, Ali Öner
Keywords
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- EP ID EP684373
- DOI 10.4274/jarem.galenos.2019.2650
- Views 176
- Downloads 0
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