The Analysis of the Outcome of Short- and Long-Segment Posterior Instrumentation for Thoracolumbar Bursting Fractures.
10.4184/jkss.2014.21.4.139
- Author:
Woo Chul KIM
1
;
Kyu Yeol LEE
;
Lih WANG
;
Young Hoon LIM
;
Jung Mo KANG
;
Hyun Su DO
Author Information
1. Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea. gylee@dau.ac.kr
- Publication Type:Original Article
- Keywords:
Thoraolumbar;
Burst fracture;
Pedicle screw;
Long segment;
Short segment
- MeSH:
Follow-Up Studies;
Fractures, Comminuted;
Humans;
Retrospective Studies
- From:Journal of Korean Society of Spine Surgery
2014;21(4):139-145
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A retrospective study. SUMMARY OF THE LITERATURE REVIEW: The reports comparing short- and long-segment instrumentation are insufficient. OBJECTIVES: To determine the postoperative results and to analyze relative factors affecting results between short- and long-segment 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 long-segment 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 follow-up 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 follow-up. The kyphotic angle decreased from 19.4degrees to 10.6degrees postoperatively, and remained at 12.8degrees at follow-up. In Group II, the ACH recovered from 41.6% to 76.4% postoperatively, and was 74.8% at follow-up. The kyphotic angle decreased from 21.6degrees to 12.6degrees postoperatively, and was 13.9degrees at follow-up. 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. CONCLUSIONS: The short- and long-segment instrumentations of thoracolumbar fractures are not significantly different with respect to the results attained. However, in order to decrease complications, we should pay attention to age and fracture comminution.
