J Korean Fract Soc.  2013 Jan;26(1):21-26. 10.12671/jkfs.2013.26.1.21.

Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level

Affiliations
  • 1Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea. jhkim@paik.ac.kr
  • 2Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.

Abstract

PURPOSE
The aim of this study is to decide the optimal level of fusion with comparing the results between the short segment fusion and long segment fusion treated with pedicle screw instrumentation, including fractured vertebra in thoracolumbar junctional fractures.
MATERIALS AND METHODS
From February 2000 to November 2009, fifty three patients with junctional fracture of thoracolumbar spine were treated with pedicle screws and posterior fusion at our hospital. They were divided into two groups, the short segment group and long segment group. Preoperatively, immediate postoperative and last follow-up lateral radiological evaluation was done by measuring the correction and loss of segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle. In addition, operation time and amount of intraoperative bleeding were measured.
RESULTS
There were no significant differences of statistical analysis regarding the radiological variables between the two groups, especially the loss of corrected segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle (p>0.05). However, operative time in the short segment group (234 minutes) was shorter than the long segment group (284 minutes), and there was statistical significance (p=0.002).
CONCLUSION
We recommend the short segment transpediculr instrumentation one level above and one level below, including the fractured vertebra for thoracolumbar junctional fracture with 6 points or less of the load-sharing score.

Keyword

Thoracolumbar spine; Spine fracture; Posterior fixation; Fusion level

MeSH Terms

Follow-Up Studies
Hemorrhage
Humans
Kyphosis
Operative Time
Spine

Figure

  • Fig. 1 Radiologic parameters. (A) Kyphotic angle (°). (B) Wedge angle (°). (C) Compression rate (%). (D) Instrumented vertebra angle (°).


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