Viability and long-term survival of short-segment posterior fixation in thoracolumbar burst fractures.

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Abstract

[Indexed for MEDLINE] 14. Clin Neurol Neurosurg. 2017 Feb;153:56-63. doi: 10.1016/j.clineuro.2016.12.011. Epub 2016 Dec 21. Posterior short-segment fixation in thoracolumbar unstable burst fractures - Transpedicular grafting or six-screw construct? Liao JC(1), Fan KF(2). Author information: (1)Department of Orthopedics Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Electronic address: jcl1265@adm.cgmh.org.tw. (2)Department of Orthopedics Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. OBJECTIVES: Early implant failure and donor-site complication remain a concern in patients with thoracolumbar burst fracture underwent one-above and-below short-segment posterior pedicle screw fixation with fusion. Our aim was to evaluate the results of short-segment pedicle instrumentation enforced by two augmenting screws or injectable artificial bone cement in the fractured vertebra, and compare the differences between these two PATIENTS AND METHODS: We conducted a retrospective clinical and radiographic study. Twenty-seven patients were treated with a six-screw construct (group 1), and twenty-nine patients underwenta four-screw construct and fractured vertebra augmentation by injectable calcium sulfate/phosphate cement (group 2). Posterior or posterolateral fusions were not performed in both groups. The severity of the fractured vertebra was evaluated by the load-sharing classification (LSC). Local kyphosis and anterior body height of the fractured vertebra were measured and were follow-up at least 2 years. Any implant failure or loss of correction >10° degrees at the final was defined as failure of surgery. Patients' clinical results were assessed by the Denis scale. RESULTS: Blood loss and operation time were less in group 1 (126.2±9.7 vs. 267.6±126.1ml, p