A Comparative Analysis of the Efficacy of Short-Segment Pedicle Screw Fixation with that of Long-Segment Pedicle Screw Fixation for Unstable Thoracolumbar Spinal Burst Fractures

Hur, Jun

doi:10.11648/j.cmr.20150401.11

Cited by 6 publications

(7 citation statements)

References 24 publications

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“…Absolute indication of early surgery is progressive neurological deficit 7 . Other indication for surgical intervention are incomplete neurological deficit, >25-300 angle of kyphotic deformity, >50% of loss of vertebral body height, and >40-50% of canal narrowing 8 .…”

Section: Introductionmentioning

confidence: 99%

Outcome of Unstable Thoracolumbar Fracture Following Long Segment Posterior Fixation

Choudhury

Alam

Azad³

et al. 2021

J. Bangladesh Coll. Phys.

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Introduction: Fractures of the thoracolumbar region are the most common injuries of the vertebral column and burst fractures are the most frequent. The purpose of this study was to see the radiological and functional outcome after long segment posterior fixation in unstable thoracolumbar spine injury with incomplete neurological deficit. Methods: A total of 146 cases were included in this prospective case series from January 2014 to December 2018 through non randomized purposive sampling. All the patients were operated with long segment posterior fixation and postero-lateral fusion by Autogenous cancellous bone graft. Postoperative functional outcome was assessed both clinically by ODI, VAS, ASIA and radiologically by Bridwell criteria. Postoperative follow up was conducted at 2nd, 6th,12th and finally 6 monthly. Results: The mean Cobb angle at pre-operative was 21.5 ±8.9 and at final follow-up was 11±4.57 in this study (p-value<0.05). At final follow up 1 grade improvement occurred in 116(79.5%) patients and 2 grade improvement in 36 (20.5%). Regarding ODI and VAS, moderate disability (25%) with mild pain (16%) was found at final follow up with a Bridwell fusion grade II (48%). Conclusion: Long segment transpedicular screw fixation in unstable thoracolumbar spine injury with incomplete neurological deficit is an effective method of treatment. This method enhances neurological and functional recovery with an acceptable fusion rate J Bangladesh Coll Phys Surg 2021; 39(2): 114-122

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Section: Introductionmentioning

confidence: 99%

Outcome of Unstable Thoracolumbar Fracture Following Long Segment Posterior Fixation

Choudhury

Alam

Azad³

et al. 2021

J. Bangladesh Coll. Phys.

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“…Multiple variables have to be considered when treating thoracolumbar fractures such as the type and stability of the fracture, degree of comminution, and neurological status. 24 Very few studies have compared between long-segment and shortsegment posterior fixation, 11,22 and all of them have mixed fracture severity ranging from type A to C according to the AO Classification of thoracolumbar fractures. This prospective randomized controlled trial included only patients with Type A3 and A4 burst fractures, and compared the clinical and radiological outcome between the long-segment fixation with that of short-segment fixation with one or two intermediate screws in the fractured vertebra.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Kim et al, 17 suggested that short-segment pedicle screw fixation with inserting one or two screws in the fractured level was enough in the management of selected young patients with unstable burst fracture. Hur et al, 11 who compared between long and short segment fixation, concluded that the loss of kyphosis correction, and the clinical outcome was not significantly different between the long-segment and short-segment group. In a recent meta-analysis comparing between long and short segment fixation, no significant difference was identified between the two groups regarding radiological outcome, functional outcome, neurologic improvement, and implant failure rate.…”

Section: Discussionmentioning

confidence: 99%

Short Versus Long Segment Fixation for Thoracolumbar Burst Fractures: A Randomized Controlled Trial

El-Sharkawi

Gawad

Sabrout

et al. 2017

Egyptian Spine Journal

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Background Data: Selection of stabilization procedures for treating thoracolumbar burst fractures remains controversial. Both long-segment and short-segment pedicle screw fixation including the fractured vertebral body have been used widely with no consensus on the better method. Purpose: To compare between the long segment and short-segment with intermediate screw (s) fixation of thoracolumbar junction burst fractures in terms of radiological and clinical outcomes. Study Design: Prospective randomized controlled trial. Patients and Methods: Fifty consecutive patients (32 males and 18 females, mean age 33.6±14.6 years) with thoracolumbar burst fractures presenting during the period between October 2015 and December 2016 to Assiut University hospital were randomized into one of two groups. Group A (25 patients) was treated by long segment pedicle screw fixation, i.e., fixation of 2 levels above and below the fractured vertebra. Group B (25 patients) was treated by short segment fixation, i.e., 1 level above and 1 level below the fractured vertebra, with one or 2 intermediate screws in the fractured vertebra itself. The study protocol was approved by our institution review board and all patients signed an informed consent. The inclusion criteria were single level Type A3 and A4 fracture at thoracolumbar junction, regardless of their neurological status. All patients were treated within 48 hours from the injury. Monoaxial screws were used in all patients. Assessment of kyphosis correction by using the Cobb method and restoration of the anterior vertebral body height was performed radiologically postoperatively and at 3 and 6 months follow up. The clinical outcomes were evaluated using the modified Macnab criteria in the last follow-up. Radiological and clinical assessment was made by an independent observer. Results: Demographic data of both groups were quite comparable. The mean operative time in Group B was significantly shorter than in group A (85±28 min. and 110±0.59 min. respectively). The mean operative blood loss was also significantly lower in Group B than in Group A (476±133.2cc and 656±195.9cc respectively). There was no significant difference between both groups as regards the degree of local kyphosis angle correction and anterior vertebral body height restoration or the correction loss observed during the follow up. Neurological recovery was observed in all patients. Clinically, 14 (56%) patients 7

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“…However, there is no consensus regarding the best surgical approach. Nevertheless, spine surgeons often prefer the posterior approach because of its easy application, reduction of intraoperative bleeding and low degree of invasiveness [8]. It has become the most used method in the surgical treatment of thoracolumbar burst fractures with advantages such as more safety in exploring the surgical site without violating the pulmonary, visceral, and vascular structures, being less technically demanding and familiar to a spine surgeon [9].…”

Section: Introductionmentioning

confidence: 99%

Short segment versus long segment pedicle screws fixation in management of thoracolumbar burst fractures

El-Khadarway¹,

Ragab²,

Mostafa³

2022

ijhs

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Background: Selection of stabilization procedures for treating thoracolumbar burst fractures remains controversial. Both long-segment and short-segment pedicle screw fixation have been used widely with no consensus on the better method. Aim of study: To compare the outcome of long segment and short segment posterior fixation as amanagement of thoracolumbar burst fractures. Patients and Methods: 60 patients fulfilling the inclusion criteria who underwent posterior pedicle screw fixation for burst fracture of thoracolumbar spine in Neurosurgery Department of Al-Azhar University Hospitals and El-Ahrar General Hospital, Zagazig between August 2019 and Febrauray 2022. Patients were randomized into one of two groups. Short segment group (30 patients) was treated by short segment fixation, i.e., 1 level above and 1 level below the fractured vertebra. Long segment group (30 patients) was treated by long segment pedicle screw fixation, i.e., fixation of 2 levels above and below the fractured vertebra. Assessment of kyphosis correction by using the Cobb method and restoration of the anterior vertebral body height was performed radiologically postoperatively and at 3 and 6 months follow up. Results: Demographic data of both groups were quite comparable. thoracolumbar burst fracture

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A Comparative Analysis of the Efficacy of Short-Segment Pedicle Screw Fixation with that of Long-Segment Pedicle Screw Fixation for Unstable Thoracolumbar Spinal Burst Fractures

Cited by 6 publications

References 24 publications

Outcome of Unstable Thoracolumbar Fracture Following Long Segment Posterior Fixation

Outcome of Unstable Thoracolumbar Fracture Following Long Segment Posterior Fixation

Short Versus Long Segment Fixation for Thoracolumbar Burst Fractures: A Randomized Controlled Trial

Short segment versus long segment pedicle screws fixation in management of thoracolumbar burst fractures

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