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Corresponding Author

Moustafa Mohamed Saad

Subject Area

Thoracolumbar junction, Trauma

Document Type

Original Study

Abstract

Background data: Posterior instrumentation of thoracolumbar burst fracture is an excellent fixation method. Numerous methods depend on the number of fixed vertebrae. Both short-segment fixation, including the fractured vertebra (SSFIS), and long-segment fixation (LSF) have been widely used with no consensus on the better method.

Purpose: This study aims to compare the LSF and SSFIS in thoracolumbar spine fracture in terms of radiological and clinical outcomes.

Study design: This is a prospective comparative study.

Patients and methods: Twenty patients with thoracolumbar burst fractures were treated with posterior pedicle screw fixation and divided into two groups, with 10 patients each, based on the number of instrumented levels LSF group and SSFIS. The patients were evaluated for local kyphotic angle (LKA) correction, anterior vertebral body height loss (AVHL), Visual Analogue Scale (VAS) for back pain, and Oswestry Disability Index (ODI) for functional outcome.

Results: No statistically significant differences were observed between the two groups regarding patient age, sex, reduction of VAS for back pain, change in functional outcome assessed by ODI postoperatively, correction of LKA, and restoration of AVHL. However, there was a statistically significant difference favoring the SSFIS group regarding operative time, intraoperative amount of blood loss, incision length, and ODI at the six-month follow-up.

Conclusion: Our data suggest that SSFIS seems comparable to LSF in managing thoracolumbar fractures resulting in adequate correction of LKA, restoration of AVHL, and preserving more motion segments.

Keywords

thoracolumbar fracture, intermediate screw, pedicle screw fixation, short-segment fixation, long-segment fixation

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