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- OpenAccess
Two Additional Augmenting Screws with Posterior Short-Segment Instrumentation without Fusion for Thoracolumbar Burst Fracture: Clinical and Radiographic Outcomes
並列摘要
Background/Purpose: Posterior short-segment instrumentation (one screw above and one screw below) for unstable thoracolumbar burst fracture has a high rate of implants failure. The aim of this study was to determine whether short-segment instrumentation with two additional augmenting screws in the injured vertebra is sufficient to treat thoracolumbar burst fracture. Methods: Nineteen consecutive patients with single-level thoracolumbar burst fracture treated with short-segment pedicle screw fixation and two additional augmenting screws between January 2010 and December 2011 were studied. Preoperative, immediate postoperative, and one-year follow-up radiographs were assessed. We also used the Denis classification system to evaluate final clinical outcome. Results: Average blood loss was 98.9 ± 71.5 mL and average operating time was 140.2 ± 56.2 minutes. Mean preoperative, immediate postoperative, and one-year follow-up local kyphosis angle were 22.2° ± 6.5°, 5.8° ± 4.8°, and 10.1° ± 5.2°, respectively. Mean preoperative, immediate postoperative, and one-year followup anterior body height percentage were 46.8% ± 12.2%, 84.5% ± 10.5%, and 74.1% ± 12.6%, respectively. One patient had lost more than 10° of sagittal correction at the one-year follow-up, and no patient had implant breakage. Results were excellent regarding return to work (89.5%) and pain relief. Conclusion: Short-segment instrumentation with two additional augmenting screws in the fractured vertebra is sufficient for most single-level thoracolumbar burst fractures. This fixation method is easy to perform and achieves good clinical results. Patients will require a second surgery to remove the implants after union is confirmed.
延伸閱讀
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