Posterior Fixation with Unilateral Same Segment Pedicle Fixation and Contralateral Hook in Surgical Treatment of Thoracolumbar Burst Fractures
Zahedan Journal of Researches in Medical Sciences
In surgical treatment of thoracolumbar burst fractures, most authors try to lower the number of vertebrae involved during the surgery. Objectives: The aim of this study was to evaluate the outcome of a medium-segment posterior spinal fixation in these patients. Patients and Methods: We retrospectively reviewed 27 patients (18 male, 9 female) with mean age of 39.4 ± 15.0 years old in a before-and-after study. The mean follow-up period was 38.4 ± 15.6 months. We involved 2 intact above vertebrae
... nd one intact below vertebra, inserting a pedicular screw at the fractured level and supplemented the construct with contralateral infralaminar hook. Clinical and radiologic characteristics were assessed with American spinal injury association (ASIA) scale, oswestry disability index (ODI), visual analogue scale (VAS), and plain radiography. Data analysis was carried out by SPSS version 11.5 software. Results: Mean post traumatic kyphosis was + 15.7°± 3.3°that was changed to -8.5°± 4.3°and +1°± 4.4°at immediate and last visit after surgery, respectively. Mean loss of correction (LOC) was 9.5°± 1.9°(P < 0.001). At the most recent follow-up visit, mean ODI and VAS were 15.0 ± 14.4 and 2.4 ± 2.5, respectively and 24 cases (88.9%) declared excellent or good clinical results. At the last follow-up visit, LOC had no significant correlation neither with VAS nor ODI. Conclusions: In surgical treatment of thoracolumbar burst fractures, a medium-segment posterior spinal fixation, although cannot maintain the radiologic reduction of the fractured vertebrae efficiently, is not only associated with acceptable clinical outcome but also spare one lower intact lumbar segment and therefore recommended.