EN | TR
E-ISSN: 1307-5608
Including the Fractured Vertebra in Stabilization of Thoracolumbar Vertebral Fractures: Our Single-Centered Early Stage Clinical and Radiological Results
PDF
Cite
Share
Request
Research Article
VOLUME: 75 ISSUE: 3
P: 342-347
September 2022

Including the Fractured Vertebra in Stabilization of Thoracolumbar Vertebral Fractures: Our Single-Centered Early Stage Clinical and Radiological Results

J Ankara Univ Fac Med 2022;75(3):342-347
DOI: 10.4274/atfm.galenos.2022.86648
Faruk Tonga
1. Amasya Üniversitesi Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Amasya, Türkiye
No information available.
No information available
Received Date: 30.03.2022
Accepted Date: 24.07.2022
Publish Date: 18.10.2022
PDF
Cite
Share
Request

ABSTRACT

Objectives:

To compare the early stage clinical and radiological results of patients suffering from thoracolumbar vertebral fracture, who we operated with the long segment (LS) and short segment (SS+) stabilization techniques, including the fractured vertebra.

Materials and Methods:

Thirty-eight patients who were operated in our clinic for T11-L2 vertebral fracture between January 2014 and August 2021 were included in the study. The radiological and clinical results obtained retrospectively for two different operating techniques were compared. The visual analogue scale (VAS) was used for evaluating pain intensity.

Results:

There were 17 female and 21 male patients. The mean age was 40.39 years. Of the patients, 28 were operated due to traffic accidents, 10 due to falls. LS was performed in 20 patients and SS+ was performed in 18 patients. Operation times, blood loss, preoperative local kyphosis angle and corpus anterior height loss, postoperative mobilization time, postoperative VAS, hospital stay, postoperative local kyphosis angle and corpus anterior height loss for LS and SS+ patients were 171-141 min, 400-300 mL, 11.70°-11.11°, 46-45%, 1.7-1.1 day, 4.8-3.3, 6.4-4.6 day, 5.30°-4.89°, and 29.70-30%, respectively. In the SS+ group, there were statistically significant differences in terms of operation times, blood loss, postoperative VAS values, postoperative mobilization time and number of days of hospitalization compared to the LS patients group. There was no difference in radiological measurements.

Conclusion:

The early stage clinical results of SS+ stabilization including the fractured vertebra may be better than LS stabilization. Further clinical studies are needed on this subject.

Keywords: Local Kyphosis Angle, Anterior Corpus Height Loss, Fractured Vertebra, Posterior Stabilization, Thoracolumbar Fracture

References

1
Vaccaro AR, Schroeder GD, Kepler CK, et al. The surgical algorithm for the AOSpine thoracolumbar spine injury classification system. Eur Spine J. 2016;25:1087-1094.
2
Paşahan R, Doğan Ş. Torakolomber Bileşke Kırıklarına Yaklaşım. Türk Nöroşir Derg. 2020;30:428-431.
3
Kuklo TR, Polly DW, Owens BD, et al. Measurement of thoracic and lumbar fracture kyphosis: evaluation of intraobserver, interobserver, and technique variability. Spine (Phila Pa 1976). 2001;26:61-5; discussion 66.
4
Mumford J, Weinstein JN, Spratt KF, et al. Thoracolumbar burst fractures. The clinical efficacy and outcome of nonoperative management. Spine (Phila Pa 1976). 1993;18:955-970.
5
Roy-Camille R, Saillant G, Mazel C. Internal fixation of the lumbar spine with pedicle screw plating. Clinical orthopaedics andr elated research. 1986;203:7-17.
6
Kim BG, Dan JM, Shin DE. Treatment of thoracolumbar fracture. Asian Spine J. 2015;9:133-146.
7
Scheer JK, Bakhsheshian J, Fakurnejad S, et al. Evidence-Based Medicine of Traumatic Thoracolumbar Burst Fractures: A Systematic Review of Operative Management across 20 Years. Global Spine J. 2015;5:73-82.
8
Wang ST, Ma HL, Liu CL, et al. Is fusion necessary for surgically treated burst fractures of the thoracolumbar and lumbar spine?: a prospective, randomized study. Spine (Phila Pa 1976). 2006;31:2646-52; discussion 2653.
9
Anekstein Y, Brosh T, Mirovsky Y. Intermediate screws in short segment pedicular fixation for thoracic and lumbar fractures: a biomechanical study. J Spinal Disord Tech. 2007;20:72-77.
10
Dick JC, Jones MP, Zdeblick TA, et al. A biomechanical comparison evaluating the use of intermediate screws and cross-linkage in lumbar pedicle fixation. J Spinal Disord. 1994;7:402-407.
11
Farrokhi MR, Razmkon A, Maghami Z, et al. Inclusion of the fracture level in short segment fixation of thoracolumbar fractures. Eur Spine J. 2010;19:1651-1656.
12
Tian JW, Wang L, Xia T, et al. Posterior short-segmental fixation combined with intermediate screws vs conventional intersegmental fixation for monosegmental thoracolumbar fractures. Orthopedics. 2011;34:e389-e396.
13
Li K, Zhang W, Liu D, et al. Pedicle screw fixation combined with intermediate screw at the fracture level for treatment of thoracolumbar fractures: a meta-analysis. Medicine (Baltimore). 2016;95:e4574.
14
Norton RP, Milne EL, Kaimrajh DN, et al. Biomechanical analysis of four- versus six-screw constructs for short-segment pedicle screw and rod instrumentation of unstable thoracolumbar fractures. Spine J. 2014;14:1734-1739.
15
Kanna RM, Shetty AP, Rajasekaran S. Posterior fixation including the fractured vertebra for severe unstable thoracolumbar fractures. Spine J. 2015;15:256-264.
16
Gajjar SH, Menon HJ, Chaudhari N, et al. Outcomes of Short Segment Posterior Instrumentation in Unstable Thoracolumbar Fractures. J Clin Diagn Res. 2016;10:RC04-RC08.
17
Zhang C, Liu Y. Combined pedicle screw fixation at the fracture vertebrae versus conventional method for thoracolumbar fractures: A meta-analysis. Int J Surg. 2018;53:38-47.
18
Çetin E, Öner A. Torakolomber kırıklarda kırık omurgaya vida yerleştirilerek uygulanan kısa segmentposteriorpedikül vidası tespiti ile uzun segment tespitin karşılaştırılması. J Acad Res Med. 2020;10:32-35.
19
Kapoen C, Liu Y, Bloemers FW, et al. Pedicle screw fixation of thoracolumbar fractures: conventional short segment versus short segment with intermediate screws at the fracture level-a systematic review and meta-analysis. Eur Spine J. 2020;29:2491-2504.
20
Wang H, Li C, Liu T, et al. Biomechanical efficacy of monoaxial or polyaxial pedicle screw and additional screw insertion at the level of fracture, in lumbar burst fracture: An experimental study. Indian J Orthop. 2012;46:395-401.
21
Basaran R, Efendioglu M, Kaksi M, et al. Finite Element Analysis of Short- Versus Long-Segment Posterior Fixation for Thoracolumbar Burst Fracture. World Neurosurg. 2019;128:e1109-e1117.
22
Bolesta MJ, Caron T, Chinthakunta SR, et al. Pedicle screw instrumentation of thoracolumbar burst fractures: Biomechanical evaluation of screw configuration with pedicle screws at the level of the fracture. Int J Spine Surg. 2012;6:200-205.
23
El-Shehaby A, Saoud K, Elayouty A. Comparison of long segment fixation versus short segment fixation with pediclescrews at the level of the fracture in the management of Thoracolumbar fractures. Egyptian Spine Journal. 2013;5:47-52.
24
Dobran M, Nasi D, Brunozzi D, et al. Treatment of unstable thoracolumbar junction fractures: short-segment pedicle fixation with inclusion of the fracture level versus long-segment instrumentation. Acta Neurochir (Wien). 2016;158:1883-1889.
25
Guven O, Kocaoglu B, Bezer M, et al. The use of screw at the fracture level in the treatment of thoracolumbar burst fractures. J Spinal Disord Tech. 2009;22:417-421.
26
Pellisé F, Barastegui D, Hernandez-Fernandez A, et al. Viability and long-term survival of short-segment posterior fixation in thoracolumbar burst fractures. Spine J. 2015;15:1796-1803.
27
El Behairy HF, M Abdelaziz A, Saleh AK, et al. Short-Segment Fixation of Thoracolumbar Fractures with Incorporated Screws at the Level of Fracture. Orthop Surg. 2020;12:170-176.
28
Ye C, Luo Z, Yu X, et al. Comparing the efficacy of short-segment pedicle screw instrumentation with and without intermediate screws for treating unstable thoracolumbar fractures. Medicine (Baltimore). 2017;96:e7893.
29
Li J, Liu L. Comparison of short-segment versusl ong-segment fixation for the treatment of thoracolumbar burst fracture: a meta-analysis. Int J Clin Exp Med. 2017;10:1750-1762.
30
Biakto KT, Usman MA, Limoa W, et al. Comparison between short segment pedicle screw fixation and long segment pedicle screw fixation for treatment of neglected single level thoracolumbar burst fracture. International Journal of Surgery Open. 2020;26:145-9.
2024 ©️ Galenos Publishing House