Saturday, November 2, 2001 1:30–2:13 pm Concurrent Session 5B: Trauma: 1:30 Short-segment pedicle instrumentation for thoracolumbar fractures with pedicle screws in the injured vertebra

Abstract

Purpose of study: To evaluate effectiveness of the short-segment pedicle fixation construct for the treatment of burst thoracolumbar fractures with a pedicle screw inserted in the fractured vertebra. The relationship between the pedicle screw and the bone fragments in the canal are analyzed both before and after pedicle screw insertion in the fractured vertebra with computed tomography (CT) scan.Methods used: Subjects were 34 patients with burst thoracolumbar fractures: 24 men and 10 women. The average age was 34 years. The most common level of fracture was L1. The average spinal canal occupation was 50%. There was no neurological deficit. The surgical procedure was a posterior approach using two pedicle screws in the fractured vertebra; two pedicle screws in the cephalad and two with pedicle-laminar claw one level caudad to the fracture. The instrumentation used is CD titanium CT scans before surgery and immediately after surgery and 6 months after surgery. Minimum follow-up was 36 months.of findings: The vertebra height was corrected and maintained in the last follow-up in all cases. The occupation of the spinal canal remained the same or improved in all cases, and there were no neurological or vascular injuries resulting from the placement of pedicle screws. There was no hardware failure and no reoperations. Bone fusion occurred in all cases.Relationship between findings and existing knowledge: The major concern is the early and late failures described in all short-segment pedicle screw instrumentation studies. However, all avoided pedicle screws in the fractured vertebra. This construct overcomes the hardware failure and loss of correction.Overall significance of findings: Our results suggest that short-segment pedicle screw instrumentation with pedicle screws in the injured vertebra is safe and effective for the treatment of burst thoracolumbar fractures without neurological deficit. Using the intermediate screw and distal pedicle-laminar claw overcomes hardware failure of the instrumentation.Disclosures: Device or drug: CD. Status: approved.Conflict of interest: No conflicts.