1.Radiological outcome of short segment posterior stabilisation and fusion in thoracolumbar spine acute fracture.
Ambrose W Y YUNG ; Paul L K THNG
Annals of the Academy of Medicine, Singapore 2011;40(3):140-144
INTRODUCTIONThe optimal management of thoracolumbar spine fractures remains a matter of controversy. The current literature implies that the use of short-segment pedicle screw fixation may be inappropriate because of its high reported failure rate. The purpose of this study is to report the short-term results of thoracolumbar burst and compression fractures treated with short-segment pedicle instrumentation.
MATERIALS AND METHODSFrom 2002 to 2007, 19 patients with thoracolumbar acute traumatic fractures were instrumented with posterior short-segment pedicle screws. The patients' case notes, operation records, preoperative and postoperative radiographs (sagittal index, anterior body compression and regional kyphosis), computed tomography scans, neurological findings (Frankel functional classification), and follow-up records up to 18 months were reviewed.
RESULTSA statistically significant difference was found between the patients' preoperative, postoperative and follow-up sagittal index, anterior body compression and regional kyphosis measurement. One case resulted in screw pedicle screw pullout and subsequently, kyphotic deformity. The patient underwent revision surgery to long-segment posterior instrumentation and fusion. None of the patients showed an increase in neurological deficit.
CONCLUSIONIn conclusion, the short-term follow-up results suggest a favourable outcome for short-segment instrumentation. Load shearing classification is essential for the selection of patient for short-segment instrumentation. However, the long-term follow-up evaluation will be needed to verify our findings.
Acute Disease ; Adult ; Analysis of Variance ; Bone Screws ; Female ; Health Status Indicators ; Humans ; Kyphosis ; diagnostic imaging ; surgery ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; injuries ; surgery ; Time Factors ; Treatment Outcome