Comparison of Short and Long-Segment Fusion in Thoracic and Lumbar Fractures

Jeong, Soon Taek; Cho, Se Hyun; Song, Hae Ryong; Koo, Kyung Hoi; Park, Hyung Bin; Chung, Un Hwa

Abstract

STUDY DESIGN: A retrospective study was designed to evaluate the clinical result and difference between short segment and long segment fixation, which was undertaken by posterior approach for thoracic and lumbar spine fractures.
OBJECTIVE
To determine and compare the mechanical maintenance and ability of correction, and clinical and neurologic recov-ery between short segment and long segment fusion group. SUMMARY OF BACKGROUND DATA: The long segment instrumentation is a cause of decrease of motion segment in thoracic and lumbar spine. In short segment fusion, screw failures were reported.
MATERIALS AND METHODS
From 1989 thorough 1997, 54 patients who had been operated on by the posterior approach with transpedicular screw fixation for spine injuries were divided into two groups. The authors applied the short segment transpedic-ular instrumentation including fractured vertebra. Short segment group included 35 cases, and long segment group, 19 cases. The mean follow-up period was one year and eight months for short segment group, two years and seven months for long segment one. The results were evaluated by comparing the anterior vertebral height, sagittal index in simple roentgenogram and neurologic recovery.
RESULTS
The average of anterior vertebral height which was 50.7% at preoperation, became 78.7% after the operation and measured 74.9% at final follow-up in long segment fusion group, while in short segment fusion group it was 59.7%, 79.3% and 77.7%, respectively. The average of sagittal index of 17.5degreeat preoperation became 6.7degreeafter the operation, and measured 8degreeat final follow-up in long segment fusion group, while in short segment fusion group it was 19.9degree, 10.4degree, and 12.1degree, respectively. Overall clinical results had no statistical significant difference between two groups. Of the thirty-six patients with neurologic deficits, twenty-two improved by over the one Frankel grade.
CONCLUSIONS
The authors conclude that the short segment transpedicular instrumentation including fractured vertebra is a successful method of thoracolumbar and lumbar burst fractures.