Short segment screw fixation without fusion in treatment for unstable thoracolumbar burst fracture

Abstract

This study aims to evaluate clinical efficacy of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture. Nineteen patients younger than 40 years old with unstable thoracolumbar burst fractures were included. The surgical procedure included postural reduction for 3 days and screw fixations at one level above, one level below and at the fractured level itself. The implants were removed 12 months after initial operation. Imaging and clinical findings were analyzed at preoperative, 12 months after surgery, just before implant removal, and at six months after implant removal. Results indicated that difference was statistically significant between preoperative period or postoperative 1 year follow-up, just before implant removal and 6 months after implant removal (P < 0.05). Results at postoperative 1 year follow-up, just before implant removal and 6 months after implant removal were better than preoperative period. There were no significant complications or neurological deterioration after screws insert and removal in any patient. The rate of clinical outcome with excellent and good was 94.7%. In conclusion, short segment pedicle screw fixation without bone fusion can be an effective and safe operative srategytechnique in the management of young patients suffering from unstable burst fracture.

Keywords: Pedicle screw fixation; bone fusion; burst fracture; short segment.

Figure 1

A 28 years old patient with L2 unstable thoracolumbar burst fracture treated with short segment screw fixation. A. Anteroposterior radiograph obtained before surgery; B. Anteroposterior view radiograph at one year after surgery; C. Anteroposterior view radiograph at final follow-up; D. Lateral radiograph obtained before surgery; E. Lateral view radiograph at one year after surgery; F. Lateral view radiograph at final follow-up.