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Abstract
Summary of the Literature Review
The reports comparing short- and longsegment instrumentation are insufficient.
Objectives
To determine the postoperative results and to analyze relative factors affecting results between short- and longsegment instrumentation in thoracolumbar fractures.
Materials and Methods
From March 2006 to March 2012, 97 patients with thoracolumbar fracture were treated with posterior instrumentation. They were divided into 2 groups, the short- (Group I) and longsegment groups (Group II). To analyze factors affecting results, several factors including age, anterior column height (ACH), and the kyphotic angle were reviewed. For radiologic evaluation, postoperative and followup radiographs were evaluated by measuring the kyphotic angle and ACH. Additionally, the presence of complications was reviewed.
Results
Groups I and II consisted of 45, 52 cases and had mean ages of 50.3, 55.8 years, respectively. In Group I, the ACH increased from 44.2% to 75.3% postoperatively, and remained 72.8% at followup. The kyphotic angle decreased from 19.4° to 10.6° postoperatively, and remained at 12.8° at followup. In Group II, the ACH recovered from 41.6% to 76.4% postoperatively, and was 74.8% at followup. The kyphotic angle decreased from 21.6° to 12.6° postoperatively, and was 13.9° at followup. The canal compromise, age, and comminution were not directly related with results. However, the mean age of the 7 cases showing complications was 72 years, and the 7 cases had severe comminuted fractures.
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Figures and Tables%
Fig. 1.
A 60-year-old female patient with L1 burst fracture treated by short segment pedicle screw fixation. (A) Preoperative X-ray (B) Postoperative X-ray (C) Preoperative CT scan.
Fig. 2.
A 31-year-old female patient with T12 burst fracture treated by long segment pedicle screw fixation. (A) Preoperative X-ray (B) Postoperative X-ray (C) Preoperative CT scan.
Table 1.
Analysis of postoperative results between short and long segment screw fixation groups
Table 2.
Risk factors in patients showing complications
Table 3.
Univariate Logistic regression analysis of risk factors in patients showing complications
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