Study Design: A retrospective study.
Summary of the Literature Review: The reports comparing short- and long- segment instrumentation are insufficient.
Objectives: To determine the postoperative results and to analyze relative factors affecting results between short- and long-segmentinstrumentation 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, postoperativeand follow-up radiographs were evaluated by measuring the kyphotic angle and ACH. Additionally, the presence of complicationswas 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 increasedfrom 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% atfollow-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, andthe 7 cases had severe comminuted fractures.
Conclusions: The short- and long-segment instrumentations of thoracolumbar fractures are not significantly different with respect tothe results attained. However, in order to decrease complications, we should pay attention to age and fracture comminution.
Key Words: Thoraolumbar, Burst fracture, Pedicle screw, Long segment, Short segment