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Abstract
Objective
The purpose of this study was to determine whether screw fixation without bone fusion in patients with a low lumbar burst fracture has satisfactory outcomes.
Methods
Twelve patients that underwent screw fixation without bone fusion for a low lumbar burst fracture (L3–5) between 2006 and 2009, were included in this study. Motor power was intact despite severe canal compromise in all. Surgical procedures included postural reduction for 2 days and screw fixation without bone fusion. Imaging and clinical findings, including level of the involved vertebra, vertebral height, canal compromise, clinical outcomes, and related complications were analyzed.
Results
Mean follow-up was 23.1±11.0 months. Mean pain score (visual analogue scale) prior to surgery was 7.8±2.0 and this decreased to 1.8±1.0 at final follow-up. In 5 patients, open screw fixation by midline skin incision was performed and 7 patients underwent percutaneous screw fixation at one level above, one level below the fractured vertebra and fractured level itself. The proportion of canal compromise at the fractured level improved significantly from 60% to 30% at final follow-up (p＜0.001). Mean preoperative vertebral height loss was 31.0%, and improved to 20.5% at final follow-up, though this improvement was not statistically significant (p＜0.001). No neurological aggravation related to neural injury was observed.
References
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FIGURE 1.
A neurologically intact 17-year-old female patient fell down and sustained a L5 burst fracture. A, B: Preoperative computed tomography scans show severe canal compromise (about 55%). C, D: Simple lateral radiograph and computed tomography scan taken at 28 months after screw fixation demonstration well maintained alignment and improved canal compromise.
FIGURE 2.
A neurologically intact 15-year-old female patient fell down and sustained an L3 burst fracture. A, B: Preoperative computed tomography scans showing severe canal compromise (about 50%) and lamina fracture. C, D: Simple lateral radiograph and computed tomography scan taken at 12 months after screw fixation demonstrating well-maintained alignment and improved canal compromise.
TABLE 1.
Clinical and radiological data of the patient
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