J Korean Orthop Assoc.  1994 Dec;29(7):1672-1678. 10.4055/jkoa.1994.29.7.1672.

Long Segment Pedicle Instrumentation and Anterior Interbody Fusion for Thoraclumbar Burst Fractures

• Wang JM
• Roh KJ
• Kim DJ
• Kim DW
• Yun YH
• Kim SW

• KMID: 2423273
• DOI: http://doi.org/10.4055/jkoa.1994.29.7.1672

Abstract

Pedicle screw systems are stronger than previously used Harrington instruments. The systems have been thought to provide sufficient stability to the thoracolumbar burst fractures by merely short segment fusion. Currently some authors reported the metal failure and the loss of correction after the short segment instrumentations. Thirty-nine patients with thoracolumbar burst fractures underwent the long segment pedicle screw instrumentation and anterior interbody fusion at Ewha University Hospital from January 1991 to October 1993. Of these patients, thirty-two were reviewed in an attempt to analyze the result of the operation technique. The mean follow-up was 26 months. L1 was the most common level and twenty patients had neurologic deficits. The anterior decompression and interbody fusion were performed 2 weeks after the posterior instrumentation. We encouraged early ambulation with TLSO brace as soon as possible. Bony union was obtained in all cases and completed at an average 4.4 months after the operation. The average preoperative kyphosis, 17.4 became 3 after the operation and it was measured 4.2 at the final follow-up. The average correction loss was 1.2. Of the twenty patients with neurologic deficit, ten improved by one Frankel grade and four improved by two grades. Postoperative complications were three cases of the donor site pain. There was no metal failure. These data suggest that the long segment pedicle screw instrumentation and anterior interbody fusion are able to provide sufficient stability and the recommendable procedure for the thoracolumbar burst fractures than short segment instrumentation.

Keyword

Spine; Fracture; Thoracolumbar; Long segment pedicle instrumentation

MeSH Terms

Braces
Decompression
Early Ambulation
Follow-Up Studies
Humans
Kyphosis
Neurologic Manifestations
Pedicle Screws
Postoperative Complications
Spine
Tissue Donors