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. 2014 May;24(4):459-65.
doi: 10.1007/s00590-013-1326-7. Epub 2013 Oct 5.

Posterior fixation of thoracolumbar burst fractures: is it possible to protect one segment in the lumbar region?

Umut Canbek  1 , Levent Karapınar, Ahmet Imerci, Ulaş Akgün, Mert Kumbaracı, Mustafa Incesu
Affiliations

Posterior fixation of thoracolumbar burst fractures: is it possible to protect one segment in the lumbar region?

Umut Canbek et al. Eur J Orthop Surg Traumatol. 2014 May.

Abstract

Background: The treatment for thoracolumbar burst fractures is controversial. The aim of this retrospective study was to compare intermediate-segment (IS) and long-segment (LS) instrumentation in the treatment for these fractures.

Methods: IS instrumentation was considered as pedicle fixation two levels above and one level below the fractured vertebra (infra-laminar hooks attached to lower vertebra with pedicle screws). LS instrumentation was done two levels above and two levels below the fractured vertebra. Among a total of 25 consecutive patients, Group 1 included ten patients treated by IS pedicle fixation, whereas Group 2 included fifteen patients treated by LS instrumentation.

Results: The measurements of local kyphosis (p = 0.955), sagittal index (p = 0.128), anterior vertebral height compression (p = 0.230) and canal diameter expansion (p = 0.839) demonstrated similar improvement at the final follow-up between the two groups. However, there was a significant difference (p < 0.05) between Group 1 and Group 2 regarding clinical outcome [Hannover scoring system, Oswestry disability questionnaire and the range of motion of the lumbar region compared to neutral (0°)].

Conclusions: The radiographic parameters were the same between the two groups. However, the clinical parameters demonstrated that IS instrumentation is a more effective management of thoracolumbar burst fractures.

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Figures

Fig. 1
Fig. 1
a Postero-anterior and b lateral radiographs of a patient with an L1 vertebra fracture who received IS instrumentation
Fig. 2
Fig. 2
a Postero-anterior and b lateral radiographs of a patient with a T12 vertebra fracture who received LS instrumentation
Fig. 3
Fig. 3
Sagittal index calculation in the lateral graphs
Fig. 4
Fig. 4
Calculation of Cobb’s angle in the lateral graphs
See this image and copyright information in PMC

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