PurposeSurgical treatment in the case of thoracolumbar burst fractures is very controversial. Posterior instrumentation is most frequently used, however, but the number of levels to be instrumented still remains a matter of debate.Materials and MethodsA total of 94 patients who had a single burst fracture between T11 and L2 were selected and were managed using posterior instrumentation with anterior fusion when necessary. They were divided into three groups as follows; Group I (n = 28) included patients who were operated by intermediate segment fixation, Group II (n = 32) included patients operated by long segment fixation, and Group III (n = 34) included those operated by intermediate segment fixation with a pair of additional screws in the fractured vertebra. The mean follow-up period was twenty one months. The outcomes were analyzed in terms of kyphosis angle (KA), regional kyphosis angle (RA), sagittal index (SI), anterior height compression rate, Frankel classification, and Oswestry Disability Index questionnaire.ResultsIn Groups II and III, the correction values of KA, RA, and SI were much better than in Group I. At the final follow up, the correction values of KA (6.3 and 12.1, respectively) and SI (6.2 and 12.0, respectively) were in Groups II and III found to be better in the latter.ConclusionThe intermediate segment fixation with an additional pair of screws at the fracture level vertebra gives results that are comparable or even better than long segment fixation and gives an advantage of preserving an extra mobile segment.
were included in the study (mono-axial screws and a 4.5 mm rod: thin rod group=19 cases; poly-axial reduction screws and a 5.5 mm diameter rod: thick rod group=20 cases). All patients were followed for over 2 years postoperatively. For the comparison of surgical outcomes between the two groups, radiographic measurements were performed in the coronal and sagittal planes.Results: Preoperative scoliosis angle (thin rod group 49.8。 , thick rod group 47.1。 ), age, BMI, Risser stage, union time, operative time, and blood loss showed no statistical difference between the two groups. Postoperative average correction rate of scoliosis angle was 69% (15.8。 ) in the thin rod group and 70% (14.1。 ) in the thick rod group. However, correction rate after 2 years was 51% (24.5。 ) in the thin rod group and 60% (18.7。 ) in the thick rod group, showing statistically significant difference. There was a tendency toward correction loss in the thin rod group (8.7。 vs. 4.6。p=0.0057).Conclusion: Postoperative correction rate was satisfactory in both groups. However, the thin rod group showed substantial correction loss. Therefore, poly-axial screws and thick rods are more suitable in VATS correction of scoliosis.
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