CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(03): 470-473
DOI: 10.1055/s-0042-1757428
Original Article

Outcome of Long-Segment Fixation versus Inclusion of the Fractured Level in Short-Segment Fixation for Thoracolumbar Junction Fractures

Eslam El Sayed El Khateeb
1   Faculty of Medicine, South Valley University, Qena, Egypt
,
Ahmed G. Tammam
1   Faculty of Medicine, South Valley University, Qena, Egypt
,
Ali R. Hamdan
1   Faculty of Medicine, South Valley University, Qena, Egypt
› Author Affiliations

Abstract

Objective The aim of this study was to compare the radiological outcomes of long-segment fixation and short-segment fixation, including the fracture level in patients treated for thoracolumbar junction fractures.

Methods Data collected from records of patients with thoracolumbar junction fractures who were operated at our department. Neurological evaluation was done using American Spinal Injury Association classification score. Radiological parameters used were the Cobb's angle, vertebral body compression ratio, the anteroposterior spinal canal diameter, and the anterior and the posterior vertebral body heights. Patients were divided into two groups: group A included patients who underwent long-segment fixation and group B included patients who underwent short-segment fixation with inclusion of the fracture level.

Results The mean preoperative Cobb angle was 22.51 degrees in group A and 19.37 degrees in group B. Both groups showed improvement in the postoperative Cobb angle as the mean in group A was 14.17 degrees and in group B was 11.77 degrees. The mean preoperative compression ratio in group A was 82.8%, while in group B it was 76%. The postoperative mean in group A was 89.2%, while in group B, it was 84%. The mean preoperative anterior vertebral body height of the fractured vertebra in group A was 16.7 mm, while in group B, it was 15.18 mm. The mean preoperative posterior vertebral body height in group A was 16.33 mm and that of group B was 19.41 mm. The mean postoperative anterior vertebral body height in group A was 17.66 mm and that of group B was 17.10 mm. The mean postoperative posterior vertebral body height in group A was 17.11 mm and that of group B was 20.79 mm.

Conclusion Posterior short-segment fixation with additional screws at the fracture level provides similar—if not better—clinical and radiological outcomes to long-segment fixation in the treatment of thoracolumbar junction fractures.



Publication History

Article published online:
08 October 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Hu R, Mustard CA, Burns C. Epidemiology of incident spinal fracture in a complete population. Spine 1996; 21 (04) 492-499
  • 2 Altay M, Ozkurt B, Aktekin CN, Ozturk AM, Dogan O, Tabak AY. Treatment of unstable thoracolumbar junction burst fractures with short- or long-segment posterior fixation in Magerl type a fractures. Eur Spine J 2007; 16 (08) 1145-1155
  • 3 Reinhold M, Knop C, Beisse R. et al. Operative treatment of 733 patients with acute thoracolumbar spinal injuries: comprehensive results from the second, prospective, Internet-based multicenter study of the Spine Study Group of the German Association of Trauma Surgery. Eur Spine J 2010; 19 (10) 1657-1676
  • 4 Koller H, Acosta F, Hempfing A. et al. Long-term investigation of nonsurgical treatment for thoracolumbar and lumbar burst fractures: an outcome analysis in sight of spinopelvic balance. Eur Spine J 2008; 17 (08) 1073-1095
  • 5 Kanna RM, Shetty AP, Rajasekaran S. Posterior fixation including the fractured vertebra for severe unstable thoracolumbar fractures. Spine J 2015; 15 (02) 256-264
  • 6 Guven O, Kocaoglu B, Bezer M, Aydin N, Nalbantoglu U. The use of screw at the fracture level in the treatment of thoracolumbar burst fractures. J Spinal Disord Tech 2009; 22 (06) 417-421
  • 7 Sodhi HBS, Savardekar AR, Chauhan RB, Patra DP, Singla N, Salunke P. Factors predicting long-term outcome after short-segment posterior fixation for traumatic thoracolumbar fractures. Surg Neurol Int 2017; 8 (01) 233
  • 8 Wang H, Zhao Y, Mo Z. et al. Comparison of short-segment monoaxial and polyaxial pedicle screw fixation combined with intermediate screws in traumatic thoracolumbar fractures: a finite element study and clinical radiographic review. Clinics (São Paulo) 2017; 72 (10) 609-617
  • 9 Bolesta MJ, Caron T, Chinthakunta SR, Vazifeh PN, Khalil S. Pedicle screw instrumentation of thoracolumbar burst fractures: biomechanical evaluation of screw configuration with pedicle screws at the level of the fracture. Int J Spine Surg 2012; 6 (01) 200-205