Comparison of Short Segment and Long Segment Posterior Instrumentation of Thoracolumbar and Lumbar Bursting Fractures at Load Sharing Score 7 or Above (흉요추부 불안정성 방출성 골절의 단분절 및 장분절 후방 고정술의 비교 - 부하분담 분류 7점 이상 -)

나화엽; 최준철; Woo-Sung Kim (김우성); Woo Suk Song (송우석); 정유훈; 박태훈; 김태환; 서강원; Young Sang Lee (이영상)

Comparison of Short Segment and Long Segment Posterior Instrumentation of Thoracolumbar and Lumbar Bursting Fractures at Load Sharing Score 7 or Above

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2013, 20(2), pp.44-50
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

나화엽 ¹, 최준철 ¹, Woo-Sung Kim ¹, Woo Suk Song ¹, 정유훈 ², 박태훈 ², 김태환 ¹, 서강원 ¹, Young Sang Lee ¹

¹분당제생병원 정형외과
²분당제생병원

Accredited

ABSTRACT

Study Design: A retrospective comparative analysis of the short-segment and long-segment posterior fixation in thoracolumbar burst fractures that are 7 points or above in load-sharing score was performed. Objectives: The purpose of this study is to demonstrate the appropriate level of fixation by comparing the results of short-segment and long-segment posterior fixation. Summary of Literature Review: There is general consensus that short-segment fixation should be done in thoracolumbar burst fractures that are 6 points or less in load-sharing classification. There is some controversy regarding whether short-segment or long-segment fixation should be done in thoracolumbar burst fractures that are 7 points or above in load-sharing classification Materials and Methods: From 1998 through 2008, 32 patients with thoracolumbar burst fractures above 7 points in load-sharing classification had been operated with short-segment (1 segment above and 1 segment below: 23 patients) or long-segment (2 segments above and 1 segment below: 9 patients) transpedicular screw fixation at the author’s institution. They were divided by two groups (group I: short-segment fixation, group II: long-segment fixation). The mean age of patients was 49.2 years old and the mean follow-up period was 2.4 years (1-7 years). In preoperative and postoperative simple radiographs, the bony unions, breakages or loosening of implants were assessed, and the losses of correction angle and anterior vertebral body height were measured. Results: In all cases, non-union or loosening of implants were not observed. There was 1 screw breakage in short-segment fixation group during the follow up period, but bony union was obtained at final follow-up. The mean score of load sharing classification was 7.3 in Group I and 7.1 in Group II, and there was no significant difference between two groups. (p>0.05) The mean anterior vertebral body height loss was 5.3% in Group I and 3.6% in Group II and the mean loss of correction angle were 4.72 in Group I and 3.38 in Group II. There was no significant difference between the two groups for both. (p>0.05)Conclusions: There was no significant difference in radiologic parameters between two groups. Short-segment fixation could be used successfully in selected cases of thoracolumbar burst fractures that are 7 points or above in load-sharing classification.

KEYWORDS

Thoracolumbar, Burst fracture, Short segment posterior fixation, Posterior fusion, Load sharing classification

Citation status

* References for papers published after 2023 are currently being built.

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