Results of treatment of unstable thoracolumbar burst fractures using pedicle instrumentation with and without fracture-level screws

Background Two different techniques of short-segment instrumentation, with and without a pedicle screw at the fracture level, were compared in thoracolumbar burst fractures in neurologically intact (ASIA-E) patients. The sagittal index, kyphosis angle (Cobb), canal compromise ratio, and compression...

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Bibliographic Details
Published in:Acta neurochirurgica 2015-05, Vol.157 (5), p.831-836
Main Authors: Ökten, Ali İhsan, Gezercan, Yurdal, Özsoy, Kerem Mazhar, Ateş, Tuncay, Menekşe, Güner, Aslan, Ali, Çetinalp, Eralp, Güzel, Aslan
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Clinical Article - Spine
Female
Fracture Fixation, Internal - instrumentation
Fracture Fixation, Internal - methods
Humans
Interventional Radiology
Lumbar Vertebrae - injuries
Male
Medicine
Medicine & Public Health
Middle Aged
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Pedicle Screws - adverse effects
Retrospective Studies
Spinal Fractures - surgery
Surgical Orthopedics
Thoracic Vertebrae - injuries
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Summary:Background Two different techniques of short-segment instrumentation, with and without a pedicle screw at the fracture level, were compared in thoracolumbar burst fractures in neurologically intact (ASIA-E) patients. The sagittal index, kyphosis angle (Cobb), canal compromise ratio, and compression ratio of the anterior vertebral height were analyzed. Methods Seventy patients who underwent short-segment stabilization for thoracolumbar (T11-L2) burst fractures in our clinic between 2008 and 2012 were included in this retrospective study. In 35 patients (group 1), a pedicle screw was placed only one level down and one level up from the fracture level. In another 35 patients (group 2), a screw was placed at the fracture level in addition to the short segment. Only neurologically intact patients with burst fractures according to the Denis classification were included. The patients were evaluated according to their age/gender, trauma etiology, and fracture level. Their preoperative and most recent postoperative follow-up radiographs and CTs were evaluated in terms of the sagittal index, kyphosis angle (Cobb), ratio of canal compromise, and anterior vertebral height. Results The two groups were similar in their ages, follow-up periods, and severity of the deformity and fracture. When the pedicle screw was placed at the fracture level in addition to short-segment stabilization, statistically significant improvements in the sagittal index ( p  
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-015-2383-y