Indications for the monosegmental stabilization of thoraco-lumbar spine fractures

Abstract

Purpose: To evaluate the efficacy and to underline the right indications of the posterior monosegmental stabilization for the treatment of thoraco-lumbar spine fractures.

Method: Twenty patients underwent a monosegmental stabilization at our Institution and were retrospectively reviewed with a minimum follow-up of two years. All the patients had a clinical and radiological assessment before, after the surgery and at final follow-up. All data were evaluated by one independent observer. Data collected were Denis pain and work scale, somatic kyphosis (SK), somatic height (SH), and compression percentage (CP).

Results: The mean pre-operative SK angle measured between the upper and lower end plate of the fractured vertebra was 23.6°. The mean SK immediately after surgery was 12.8° and at final follow-up was 13.9°. The mean pre-operative SH was 21.9 mm, the mean value after surgery was 26.5 mm, and at final follow-up was 24.8 mm. The mean pre-operative CP was 66.7%, the mean value after surgery was 80.9%, and at final follow-up was 75.3%. At final follow-up, 75% of the patients had no pain or moderate pain and 95% of the patients returned to a full time work.

Conclusions: Monosegmental stabilization with fusion is a safe and effective method to treat well selected thoracolumbar spine fractures. The right indications are type A1, type B2, and type A3 with a load sharing of less than 7 points and some very well selected type C fractures in which there is not lateral and rotatory displacement.

Keywords: Monosegmental stabilization; Pedicle fixation; Posterior approach; Spine fractures; Thoraco-lumbar fractures.