P152. Is short segment fracture fixation appropriate for AO spine type B and C injuries?

• Published in: The spine journal 2022-09, Vol.22 (9), p.S200-S200
• Main Authors: Lambrechts, Mark, D'Antonio, Nicholas, Kanhere, Arun, Dees, Azra, Wiafe, Bright M, Canseco, Jose A, Hilibrand, Alan S., Kepler, Christopher K., Vaccaro, Alexander R., Schroeder, Gregory Douglas
• Format: Article
• Language: English
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2022.06.409

The AO Spine Classifications are associated with a hierarchical injury severity score. "Type A" fractures represent the most stable injuries and "Type C" represent the most severe and unstable injuries. "Three column" subaxial cervical spine and thoracolumbar injuries are designated as Type B (tension band) and Type C (fracture dislocation). Although the load sharing classification describes burst type fractures, Type B and C injuries are often minimally comminuted but grossly unstable due to "three-column" disruption. Therefore, the load sharing classification may not be appropriate to guide short- or long-segment fixation. To identify if construct length affects the rate of surgical complications or instrumentation revision following Type B and C subaxial or thoracolumbar injuries. Retrospective cohort study. All patients with cervical or thoracolumbar Type B and Type C injuries between 2006-2021 were identified from a prospectively collected database. Only patients who underwent operative intervention were included. Surgical complications (persistent cerebrospinal fluid leak, wound dehiscence, epidural hematoma, surgical site infection) and reoperations (instrumentation revision and/or exchange). Patients were divided based on the number of levels instrumented above and below the injured level (>2 levels (long-segment) versus < 2 levels (short-segment)). Patient demographics, surgical characteristics and clinical outcomes were collected and compared. Independent t-tests or Mann-Whitney U tests compared continuous variables, while Pearson's chi-square tests compared categorical variables. Bivariate logistic regression measured the effect of fixation construct length (long-segment fixation) on the likelihood of having a surgical complication and reoperation for instrumentation revision and/or exchange. Alpha was set at P