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Short-segment versus Long-segment Stabilization for Unstable Thoracolumbar Junction Burst Fractures
M K Ahsan1, A A Mamun, Z Zahangiri
1Dr Md Kamrul Ahsan, Associate Professor of Spinal Surgery, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Mymensingh Medical Journal : MMJ
|December 7, 2017
Summary
Short-segment (SS) posterior pedicle screw fixation is as effective as long-segment (LS) fixation for treating unstable thoracolumbar junction burst fractures, offering comparable clinical and radiological outcomes.
Area of Science:
- Orthopedic Surgery
- Spinal Surgery
- Traumatology
Background:
- Unstable thoracolumbar junction burst fractures present a complex treatment challenge.
- The optimal surgical stabilization technique remains a subject of debate.
Purpose of the Study:
- To compare the clinical and radiological efficacy of short-segment (SS) versus long-segment (LS) posterior pedicle screw fixation for unstable thoracolumbar junction burst fractures.
Main Methods:
- Retrospective analysis of 88 patients with thoracolumbar burst fractures treated with posterior pedicle screw fixation.
- Patients were divided into SS (n=36) and LS (n=52) groups.
- Clinical (pain, disability, neurological deficit) and radiological (Cobb angle, sagittal index, vertebral height, canal compromise) parameters were assessed pre- and post-operatively, with follow-up at 3, 6, and 12 months.
Main Results:
- Both SS and LS fixation groups achieved satisfactory clinical outcomes based on the modified Mcnab criteria.
- Excellent/good outcomes were observed in 80.56% of the SS group and 82.69% of the LS group.
- No significant differences in key radiological parameters or overall outcomes were noted between the two fixation methods.
Conclusions:
- Short-segment pedicle screw fixation, encompassing the fractured vertebral body, demonstrates comparable efficacy to long-segment fixation for unstable thoracolumbar junction burst fractures.
- SS fixation offers a potentially less invasive and equally effective alternative for managing these injuries.
