J Korean Soc Spine Surg.  2015 Sep;22(3):92-98. 10.4184/jkss.2015.22.3.92.

The Outcomes of Short and Long Segment Posterior Instrumentation of Thoracolumbar Burst Fractures with a Load Sharing Score of 7 or More

• Seo JH
• Lee KY

• KMID: 2068926
• DOI: http://doi.org/10.4184/jkss.2015.22.3.92

Abstract

STUDY DESIGN: Retrospective.
OBJECTIVES
To investigate outcomes between short and long segment posterior instrumentation of thoracolumbar burst fractures with a load sharing score of 7 or more. SUMMARY OF LITERATURE REVIEW: Short segment instrumentation has been recommended in thoracolumbar burst fractures with a load sharing score of 6 or less, and long segment instrumentation has been recommended for those with a score of 7 or more. However, this standard is controversial.
MATERIALS AND METHODS
From March 2006 to January 2014, 45 patients with thoracolumbar fractures with a load sharing score of 7 or more were treated with posterior instrumentation. They were divided into two groups: short (group S) and long segment (group L) groups. Radiologic results were evaluated on the basis of the kyphotic angle and anterior column height. Complications were also reviewed.
RESULTS
Groups S and L consisted of 13 and 32 patients and had mean ages of 48.3 and 47.3 years, respectively. In group S, the anterior column height increased from 56.62% to 76.23% postoperatively, and remained at 71.15% at follow-up. The kyphotic angle decreased from 16.27degrees to 7.55degrees postoperatively, and was 13.17degrees at follow-up. In group L, the anterior column height recovered from 49.67% to 70.52% postoperatively, and was 63.73% at follow-up. The kyphotic angle decreased from 20.08degrees to 6.80degrees postoperatively, and was 14.18degrees at follow-up. The changes in the anterior column height and kyphotic angle were not significantly different between groups S and L. Seven cases had complications and the number of cases with complications was not significantly different between groups S and L.
CONCLUSIONS
Short and long segment instrumentation of thoracolumbar fractures with a load sharing score of 7 or more did not achieve significantly different results.

Keyword

Thoracolumbar; Burst; Segment; Fracture; Load sharing

MeSH Terms

Follow-Up Studies
Humans
Retrospective Studies

Figure

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  Fig. 1. A 48-year-old male patient with an L1 burst fracture treated by short segment pedicle screw fixation. (A) Preoperative radiograph (B) Postoperative radiograph (C) Preoperative computed tomography

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  Fig. 2. A 27-year-old male patient with an L1 burst fracture treated by long segment pedicle screw fixation. (A) Preoperative radiograph (B) Postoperative radiograph (C) Preoperative computed tomography

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