Single vs Double Index Screws in Thoracolumbar Burst Fractures: A Retrospective Analysis.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

Conflict of interest statement: Conflict of interestThe authors have no conflicts of interest to declare that are relevant to the content of this article. 12. Spine J. 2015 Aug 1;15(8):1796-803. doi: 10.1016/j.spinee.2014.03.012. Epub 2014 Mar 15. Viability and long-term survival of short-segment posterior fixation in thoracolumbar burst fractures. Pellisé F(1), Barastegui D(2), Hernandez-Fernandez A(3), Barrera-Ochoa S(4), Bagó J(5), Issa-Benítez D(6), Cáceres E(5), Villanueva C(7). Author information: (1)Spine Unit, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. Electronic address: 24361fpu@comb.cat. (2)Orthopaedics, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. (3)Spine Unit, Hospital Universitario Donostia, San Sebastián, Calle Doctor Begiristain, 117, 20080 San Sebastián, Guipúzcoa Spain. (4)Hand and Upper Extremity Unit, ICATME - Institut Universitari Quirón-Dexeus, Carrer de Sabino Arana, 5, 08028 Barcelona, Spain. (5)Spine Unit, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. (6)Spine Research, Vall d'Hebron Institut de Recerca, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. (7)Clinica del Pilar, Carrer de Balmes, 271, 08006 Barcelona, Spain. BACKGROUND CONTEXT: Short-segment pedicle screw instrumentation constructs for the treatment of thoracolumbar fractures gained popularity in the 1980s. The load-sharing classification (LSC) is a straightforward way to describe the extent of bony comminution, amount of fracture displacement, and amount of correction of kyphotic deformity in a spinal fracture. There are no studies evaluating the relevance of fracture comminution/traumatic kyphosis on the long-term radiologic outcome of burst fractures treated by short-segment instrumentation with screw insertion in the fractured level. PURPOSE: To evaluate the efficacy of the six-screw construct in the treatment of thoracolumbar junction burst fractures and the influence of the LSC score on the 2-year radiologic outcome. STUDY DESIGN: Case series of consecutive patients of a single university hospital. PATIENT SAMPLE: Consecutive patients from one university hospital with nonosteoporotic thoracolumbar burst fractures. OUTCOME MEASURES: Being a radiology-based study, the outcome measures are radiologic parameters (regional kyphosis [RK], local kyphosis, and thoracolumbar kyphosis [TLK]) that evaluate the degree and loss of correction. METHODS: Retrospective analysis of all consecutive patients with nonosteoporotic thoracolumbar burst fractures managed with a six-screw construct in a single university hospital, with more than 2 years' postoperative follow-up. RESULTS: Eighty-six patients met the inclusion criteria, and 72 (83.7%) with available data were ultimately included in the study. The sample included 53 men and 19 women, with a mean (standard deviation [SD]) age of 35.6 years (14.4 years) at the time of surgery. Mean LSC score was 6.3 (SD 1.6, range 3-9). Forty-four of 62 (70.9) fractures had a score greater than 6. Mean (SD) RK and TLK deteriorated significantly during the first 6 months of follow-up: 2.90° (4.54°) p=.005 and 2.78° (6.45°) p=.069, respectively. Surgical correction correlated significantly (r=0.521, p