Short-segment Pedicle Instrumentation of Thoracolumbar Burst-compression Fractures; Short Term Follow-up Results.
10.3340/jkns.2007.42.4.265
- Author:
Tae Sob SHIN
1
;
Hyun Woo KIM
;
Keung Suk PARK
;
Jae Myung KIM
;
Chul Ku JUNG
Author Information
1. Department of Neurosurgery, Konyang University Hospital, Daejeon, Korea. sintaesob@freechal.com
- Publication Type:Original Article
- Keywords:
Pedicle screw instrumentation;
Thoracolumbar fracture;
Short-segment;
Fixation
- MeSH:
Braces;
Follow-Up Studies*;
Fractures, Compression;
Humans;
Kyphosis;
Retrospective Studies;
Spinal Fractures
- From:Journal of Korean Neurosurgical Society
2007;42(4):265-270
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The current literature implies that the use of short-segment pedicle screw fixation for spinal fractures is dangerous and inappropriate because of its high failure rate, but favorable results have been reported. The purpose of this study is to report the short term results of thoracolumbar burst and compression fractures treated with short-segment pedicle instrumentation. METHODS: A retrospective review of all surgically managed thoracolumbar fractures during six years were performed. The 19 surgically managed patients were instrumented by the short-segment technique. Patients' charts, operation notes, preoperative and postoperative radiographs (sagittal index, sagittal plane kyphosis, anterior body compression, vertebral kyphosis, regional kyphosis), computed tomography scans, neurological findings (Frankel functional classification), and follow-up records up to 12-month follow-up were reviewed . RESULTS: No patients showed an increase in neurological deficit. A statistically significant difference existed between the patients preoperative, postoperative and follow-up sagittal index, sagittal plane kyphosis, anterior body compression, vertebral kyphosis and regional kyphosis. One screw pullout resulted in kyphotic angulation, one screw was misplaced and one patient suffered angulation of the proximal segment on follow-up, but these findings were not related to the radiographic findings. Significant bending of screws or hardware breakage were not encountered. CONCLUSION: Although long term follow-up evaluation needs to verified, the short term follow-up results suggest a favorable outcome for short-segment instrumentation. When applied to patients with isolated spinal fractures who were cooperative with 3-4 months of spinal bracing, short-segment pedicle screw fixation using the posterior approach seems to provide satisfactory result.
