Restoration of anterior vertebral height by short segment pedicle screw fixation with screwing fractured vertebra for the treatment of unstable thoracolumbar fractures.

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Restoration of anterior vertebral height by short segment pedicle screw fixation with screwing fractured vertebra for the treatment of unstable thoracolumbar fractures.

World Neurosurg. 2016 Dec 05;:

Authors: Ozdemir B, Kanat A, Erturk C, Batcik OE, Balik MS, Yazar U, Celiker FB, Metin Y, Inecikli MF, Guvercin AR

Abstract
BACKGROUND: Treatment of unstable thoraco-lumbar fractures remains controversial. Long-segment pedicle screw constructs may be stiffer and impart greater forces on adjacent segments compared with short-segment constructs.Short-segment pedicle screw fixation alone may be associated with instrumentation failure. Reinforcement fractured vertebra by additional two screws at fracture level may be usefull in thoraco-lumbar fractures for restoration of anterior vertebral height.
MATERIAL AND METHODS: We retrospectively analyzed 38 (22 males, 16 females) unstable thoracolumbar fractures. The patients were divided to two groups. In group I, patients were operated with posterior approach using pedicle screws fixed long (two levels above and one or two level below of the fractured vertebra). In groupII patients, short segment stabilization with additional screwing at fracture level was made. Immediate post operative radiological evaluations were done by measuring the correction and maintenance of kyphotic angle at the fracture level, Cobb Angle, height of fractured vertebra.
RESULTS: Average LKA,anterior kyphotic angle at the fracture level, Cobb Angle was not statistically significantly different at postoperative period (p>0.05). However, postoperative anterior height of fractured vertebra is statistically significantly different between two groups (p<0.05).
CONCLUSION: We compared a standard long-segment construct to a short-segment construct utilizing instrumentation of the fractured segment. Short segment pedicle screw fixation with screwing fractured vertebra in unstable thoracolumbar fracture level is effective method to restoring anterior vertebral height for treatment of unstable thoraco-lumbar fractures. It also provides anterior column support.

PMID: 27931944 [PubMed - as supplied by publisher]

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