Comparison between short segment pedicle screw fixation and long segment pedicle screw fixation for treatment of neglected single level thoracolumbar burst fracture

Abstract

BackgroundIn contrast with acute cases, the treatment for thoracolumbar burst fracture remains controversial between short segment and long segment pedicle screw in neglected cases, in which only little investigation is done about the proper treatment. MethodsUsing cross-sectional study, we assessed all patients with neglected single level thoracolumbar burst fracture underwent short segment or long segment pedicle screw fixation from January 2016 to June 2019 in Wahidin Sudirohusodo Hospital Makassar. We analysed the data for neurological status, radiological kyphotic angle correction, hospital length of stay, and postoperative patients’ satisfaction. ResultsTwenty-one samples were analysed. The mean age of patients was 35 ± 13 years old, consisted of 15 males (71,4%) and 6 females (28,6%). The first lumbar vertebra was the most frequently affected site of a burst fracture (71,4%). Based on ASIA Impairment Scale, the difference was insignificant (p = 0,918). Kyphotic angle correction of less than three degrees, were achieved in 20% of patients treated with short segment fixation, while the long segment counterpart achieved only 12,5%, with p = 0,579. Six out of sixteen patients (37,5%) underwent long segment fixation had poor hospital length of stay (>14 days), while none of the short segments had it, but the difference was insignificant (p = 0,246). Patients’ complain of pain was significant (p = 0,047) in fair category (VAS 3–7). ConclusionThere were no significant differences in outcome between short segment and long segment pedicle screw fixation for treatment of patient with neglected single level thoracolumbar burst fracture.