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Abstract
Study Design
A retrospective comparative analysis of the short-segment and longsegment posterior fixation in thoracolumbar burst fractures that are 7 points or above in load-sharing score was performed.
Objectives
The purpose of this study is to demonstrate the appropriate level of fixation by comparing the results of short-segment and longsegment posterior fixation.
Summary of Literature Review
There is general consensus that short-segment fixation should be done in thoracolumbar burst fractures that are 6 points or less in load-sharing classification. There is some controversy regarding whether short-segment or longsegment fixation should be done in thoracolumbar burst fractures that are 7 points or above in load-sharing classification
Materials and Methods
From 1998 through 2008, 32 patients with thoracolumbar burst fractures above 7 points in load-sharing classification had been operated with short-segment (1 segment above and 1 segment below: 23 patients) or longsegment (2 segments above and 1 segment below: 9 patients) transpedicular screw fixation at the author's institution. They were divided by two groups (group I: short-segment fixation, group II: longsegment fixation). The mean age of patients was 49.2 years old and the mean followup period was 2.4 years (1-7 years). In preoperative and postoperative simple radiographs, the bony unions, breakages or loosening of implants were assessed, and the losses of correction angle and anterior vertebral body height were measured.
Results
In all cases, non-union or loosening of implants were not observed. There was 1 screw breakage in short-segment fixation group during the follow up period, but bony union was obtained at final followup. The mean score of load sharing classification was 7.3 in Group I and 7.1 in Group II, and there was no significant difference between two groups. (p>0.05) The mean anterior vertebral body height loss was 5.3% in Group I and 3.6% in Group II and the mean loss of correction angle were 4.72 in Group I and 3.38 in Group II. There was no significant difference between the two groups for both. (p>0.05)
REFERENCES
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Figures and Tables%
Fig. 1.
(A) 37-year-old woman, L1 burst fracture, load sharing score is 7. (B) Short segment transpedicular fixation was done from T12 to L2. (C) Axial CT image shows comminution, canal encroachment. (D) Followup X-ray at 6 years shows minimal loss of correction.
Fig. 2.
(A) 52-year-old man, L1 burst fracture, load sharing score is 7. (B) Long segment transpedicular fixation was done from T11 to L2. (C) Axial CT image shows comminution, canal encroachment. (D) Followup X-ray at 2 years shows minimal loss of correction.
Table 1.
Load Sharing Classification of Spine Fracture
| Score | Comminution / involvement(%) | Apposition of fracture fragment(mm) | Angle correction |
|---|---|---|---|
| 1 | <30 | <1 | <3 |
| 2 | 30-60 | 1-2 | 4-9 |
| 3 | >60 | >2 | >10 |
Table 2.
Data analysis of all patients
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