The Radiological Outcome of Thoracolumbar Spine Fracture Fixation in Short Vs Long Segment

Abstract

Objectives: The study determined the radiological outcomes of short-segment vs. long-segment fixation of thoracolumbar spine fractures.
 Materials and Methods: A total of 322 patients (18 – 60 years) with thoracolumbar spine fractures were included. Preoperative X-rays and CT scans were performed on all patients to determine the integrity and orientation of the pedicle. Cobb's approach was also used to estimate the kyphotic angle on x-rays. The posterior pedicle 65 screw fixation was used in all instances. Group A (N = 161) received long segment fixation at least two levels above and below the fractured vertebra, while Group B (N = 161) received short segment fixation with pedicle screws placed in the broken level as well as one level above and below the fractured level.
 Results: In Group A, the mean age was 38 years, and the mean length of fracture was 45 hours; in Group B, the mean age was 43 years, and the mean duration of fracture was 46.354 hours. A good radiological outcome was observed in 115 (71.4%) patients in group A as compared to 103 (64%) patients in group B. A radiological outcome (p-value: 0.049) of a duration greater than 8 hours was observed in both groups (A: 75.5%; B: 58.1%).
 Conclusion: Short segment fixation using a pedicle screw at the level of fracture provides comparable correction to long segment fixation.
 Keywords: Thoracolumbar Fractures, Short Segment, Long Segment, Radiological Outcome.