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KMID : 0388720140210040139
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Journal of Korean Society of Spine Surgery
2014 Volume.21 No. 4 p.139 ~ p.145
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The Analysis of the Outcome of Short- and Long-Segment Posterior Instrumentation for Thoracolumbar Bursting Fractures
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Kim Woo-Chul
Lee Kyu-Yeol
Wang Lih
Lim Young-Hoon
Kang Jung-Mo
Do Hyun-Su
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Abstract
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Study Design: A retrospective study
Objectives: To determine the postoperative results and to analyze relative factors affecting results between short- and long-segment instrumentation in thoracolumbar fractures.
Materials and Methods: From March 2006 to March 2012, 97 patients with thoracolumbar fracture were treated with posterior instrumentation. They were divided into 2 groups, the short- (Group I) and long-segment groups (Group II). To analyze factors affecting results, several factors including age, anterior column height (ACH), and the kyphotic angle were reviewed. For radiologic evaluation, postoperative and follow-up radiographs were evaluated by measuring the kyphotic angle and ACH. Additionally, the presence of complications was reviewed.
Results: Groups I and II consisted of 45, 52 cases and had mean ages of 50.3, 55.8 years, respectively. In Group I, the ACH increased from 44.2% to 75.3% postoperatively, and remained 72.8% at follow-up. The kyphotic angle decreased from 19.4° to 10.6° postoperatively, and remained at 12.8° at follow-up. In Group II, the ACH recovered from 41.6% to 76.4% postoperatively, and was 74.8% at follow-up. The kyphotic angle decreased from 21.6° to 12.6° postoperatively, and was 13.9° at follow-up. The canal compromise, age, and comminution were not directly related with results. However, the mean age of the 7 cases showing complications was 72 years, and the 7 cases had severe comminuted fractures.
Conclusions: The short- and long-segment instrumentations of thoracolumbar fractures are not significantly different with respect to the results attained. However, in order to decrease complications, we should pay attention to age and fracture comminution.
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KEYWORD
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Thoraolumbar, Burst fracture, Pedicle screw, Long segment, Short segment
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