Abstract
BackgroundThoracic and lumbar fractures represent nearly 90% of traumatic spine injuries. Thoracolumbar region is susceptible to injury because of its location between the stiff kyphotic thoracic spine and the mobile lordotic lumbar region. To compare between short-segment fixation with screws into index level and long-segment fixation in maintaining angle of correction and pain.MethodsA prospective study included 91 patients, who had single-level thoracolumbar fracture with Cobb’s angle ≤ 25° and underwent posterior fixation. Forty-four patients underwent short-segment fixation with screws into the index level, and 47 patients underwent long-segment fixation with skipped index level. The angle of correction, pain, and neurological state were regularly assessed.ResultsForty-four patients (48.35%) had short segment and 47 (51.65%) had long-segment fixation. In the short segment group, the pre-operative mean Cobb’s angle was 19.34° ± 3.63° and the angle of correction was 8.14° ± 1.9° after 1 year, while in the long segment group, the pre-operative mean Cobb’s angle was 19.08° ± 4.0° and the angle of correction was 8.62° ± 2.59°. Regarding pain, in the short segment group, the pre-operative visual analogue scale (VAS) was 5.59 ± 2.09 that was reduced to 1.39 ± 0.58 at the 1 year follow-up, while the long segment group VAS was 5.4 ± 2.01 pre-operatively that was reduced to 1.47 ± 0.58.ConclusionsShort-segment fixation can maintain the angle of correction as long-segment fixation for single level thoracolumbar traumatic fracture with lower complication and faster pain relief.Trial registrationClinicaltrials.gov/NCT03272243. Registered: 1 September 2017.
Highlights
Thoracic and lumbar fractures represent nearly 90% of traumatic spine injuries
Patients included in this study had thoracolumbar spine instability including wedge fracture or burst fracture with Thoraco-Lumbar Injury Classification and Severity (TLICS) score ≥ 4 and fulfilling the study inclusion criteria which were (1) single-level fracture, (2) less than 50% of spinal canal compromised, (3) mild kyphosis or scoliosis, Cobb’s angle ≤ 25°, and (4) with or without neurological deficit
The type of fractures were variable, 38 patients presented with burst fracture (41.75%), 26 patients with wedge fracture (28.57%), 15 patients had hyperextension fractures (16.48%), and 12 patients with shears fracture (13.18%)
Summary
Thoracic and lumbar fractures represent nearly 90% of traumatic spine injuries. Thoracolumbar region is susceptible to injury because of its location between the stiff kyphotic thoracic spine and the mobile lordotic lumbar region. Thoracolumbar fractures occur when the vertebra is subjected to a significant axial and possibly flexion force vector that brings the failure of the anterior vertebral body in compression. This region (T10–L2) is uniquely susceptible to this mechanism of injury as a result of its. Sallam et al Egyptian Journal of Neurosurgery (2019) 33:11 Data obtained from those studies suggested that the use of transpedicular screws at the fractured level provides the advantages of a stiffer construct, an increased biomechanical stability, and the effect of 3point fixation of the unstable segment guard against failure of the construct [4]. Long-segment fixation may be chosen as another treatment method [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
