Short Arthrodesis Is as Effective as Long Arthrodesis for the Treatment of Type B Thoracolumbar Spine Fractures

Abstract

Objective: Thoracolumbar spine trauma is a world wide health concern that especially affects males of working age, being associated with an elevated morbidity. AO SPINE Type B fractures are unstable and require surgical stabilization. However, the decision between short or long fixation remains controversial. The objective of this study is to analyze the neurological, orthopedic and functional outcomes in patients with Type B spine fractures who have undergone short and long segment posterior arthrodesis. Methods: A prospective cohort study was performed at the Neurosurgery Department of Hospital Cristo Redentor from January 1, 2013 to December 31, 2018. Patients with spine fractures classified as AO SPINE Type B in the thoracic or thoracolumbar segments were eligible for the study. The variables analyzed included demographic data, information about the trauma, neurological status, the treatment performed, and the outcome. Results: A total of 31 patients were included in the study. The majority were Caucasian males with a mean age of 42.6(±15.6), and the main cause of the spine trauma was falling from height (N=18; 56.2%). Fifteen patients (48.3%) had subtype B1 fractures and 16 (51.6%) had subtype B2 fractures. Eleven (35.4%) patients were submitted to short arthrodesis and 20 (64.5%) were submitted to long arthrodesis. There was no statistical difference between groups in terms of neurological, orthopedic and functional outcomes. Conclusions: There is no difference in outcomes between short or long constructs for patients with type B single fracture in the thoracic, thoracolumbar and lumbar spine segments. Level of evidence III; Therapeutic Studies – Investigation of treatment results.