The Outcomes of Short and Long Segment Posterior Instrumentation of Thoracolumbar Burst Fractures with a Load Sharing Score of 7 or More (부하분담점수 7점 이상인 흉요추부 방출성 골절에서 단분절 및 장분절 후방 고정술의 결과)

서정호; 이규열

The Outcomes of Short and Long Segment Posterior Instrumentation of Thoracolumbar Burst Fractures with a Load Sharing Score of 7 or More

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2015, 22(3), pp.92-98
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

서정호 ¹, 이규열 ¹

¹동아대학교

Accredited

ABSTRACT

Study Design: Retrospective. Objectives: To investigate outcomes between short and long segment posterior instrumentation of thoracolumbar burst fractures with a load sharing score of 7 or more. Summary of Literature Review: Short segment instrumentation has been recommended in thoracolumbar burst fractures with a load sharing score of 6 or less, and long segment instrumentation has been recommended for those with a score of 7 or more. However, this standard is controversial. Materials and Methods: From March 2006 to January 2014, 45 patients with thoracolumbar fractures with a load sharing score of 7 or more were treated with posterior instrumentation. They were divided into two groups: short (group S) and long segment (group L) groups. Radiologic results were evaluated on the basis of the kyphotic angle and anterior column height. Complications were also reviewed. Results: Groups S and L consisted of 13 and 32 patients and had mean ages of 48.3 and 47.3 years, respectively. In group S, the anterior column height increased from 56.62% to 76.23% postoperatively, and remained at 71.15% at follow-up. The kyphotic angle decreased from 16.27° to 7.55° postoperatively, and was 13.17° at follow-up. In group L, the anterior column height recovered from 49.67% to 70.52% postoperatively, and was 63.73% at follow-up. The kyphotic angle decreased from 20.08° to 6.80° postoperatively, and was 14.18° at follow-up. The changes in the anterior column height and kyphotic angle were not significantly different between groups S and L. Seven cases had complications and the number of cases with complications was not significantly different between groups S and L. Conclusions: Short and long segment instrumentation of thoracolumbar fractures with a load sharing score of 7 or more did not achieve significantly different results.

KEYWORDS

Thoracolumbar, Burst, Segment, Fracture, Load sharing

Citation status

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

[journal] McLain RF / 2006 / The biomechanics of long versus short fixation for thoracolumbar spine fractures / Spine(Phila Pa 1976) 31(Suppl) : 70~79

[journal] Jeong ST / 1999 / Comparison of Short and Long-Segment Fusion in Thoracic and Lumbar Fractures / J Korean Soc Spine Surg 6 : 73~80

[journal] Mahar A / 2007 / Short-segment fixation of lumbar burst fractures using pedicle fixation at the level of the fracture / Spine(Phila Pa 1976) 32 : 1503~1507

[journal] McCormack T / 1994 / The load sharing classification of spine fractures / Spine (Phila Pa 1976) 19 : 1741~1744

[journal] Parker JW / 2000 / Successful shortsegment instrumentation and fusion for thoracolumbar spine fractures-A consecutive 4(1)/(2)-year series / Spine(Phila Pa 1976) 25 : 1157~1169

[journal] Lee KY / 2001 / Posterior Short-Segment Instrumentation of Thoracic and Lumbar Bursting Fractures : Retrospective study related with Load-Sharing classification / J Korean Soc Spine Surg 8 : 497~503

[journal] Altay M / 2007 / Treatment of unstable thoracolumbar junction burst fractures with short-or long-segment posterior fixation in magerl type a fractures / Eur Spine J 16 : 1145~1155

[journal] 나화엽 / 2013 / Comparison of Short Segment and Long Segment Posterior Instrumentation of Thoracolumbar and Lumbar Bursting Fractures at Load Sharing Score 7 or Above / 대한척추외과학회지 / 대한척추외과학회 20(2) : 44~50

[journal] Cotrel Y / 1988 / New universal instrumentation in spinal surgery / Clin Orthop Relat Res 227 : 10~23

[journal] Roy-Camille R / 1986 / Internal fixation of the lumbar spine with pedicle screw plating / Clin Orthop Relat Res 203 : 7~17

[journal] McLain RF / 1993 / Early failure of short-segment pedicle instrumentation for thoracolumbar fractures. A preliminary report / J Bone Joint Surg Am 75 : 162~167

[journal] Chung JY RI / 1994 / Short segment transpedicular Cotrel-Dubousset instrumentation including involved vertebra for fractures of thoracic and lumbar spine / J Korean Orthop Assoc 29 : 940~948

[journal] 이윤수 / 2005 / Long-term Follow-up Results of Short-segment Posterior Screw Fixation for Thoracolumbar Burst Fractures / 대한신경외과학회지 / 대한신경외과학회 37(6) : 416~421

[journal] Lee CS / 2001 / Decision of Posterior Fixation Level by Load-Sharing Classification in Thoracolumbar and Lumbar Burst Fracture / J Korean Soc Spine Surg 8 : 27~38

[journal] 김정환 / 2005 / Treatment of Thoraco-Lumbar Bursting Fractures According to Load-Sharing Classification / 대한골절학회지 / 대한골절학회 18(1) : 69~75

[journal] Wei FX / 2010 / Transpedicular fixation in management of thoracolumbar burst fractures: monosegmental fixation versus short-segment instrumentation / Spine (Phila Pa 1976) 35 : E714~E720

[journal] James KS / 1994 / Biomechanical evaluation of the stability of thoracolumbar burst fractures / Spine(Phila Pa 1976) 19 : 1731~1740

[journal] Alanay A / 2004 / Course of nonsurgical management of burst fractures with intact posterior ligamentous complex : an MRI study / Spine(Phila Pa 1976) 29 : 2425~2431

[journal] Radcliff K / 2012 / Does the loadsharing classification predict ligamentous injury, neurological injury, and the need for surgery in patients with thoracolumbar burst fractures? / J Neurosurg Spine 16 : 534~538

[journal] 김우철 / 2014 / The Analysis of the Outcome of Short- and Long-Segment Posterior Instrumentation for Thoracolumbar Bursting Fractures / 대한척추외과학회지 / 대한척추외과학회 21(4) : 139~145

[journal] Willen J / 1990 / The natural history of burst fractures at the thoracolumbar junction / J Spinal Disord 3 : 39~46

[journal] Pau A / 1994 / Can lacerations of the thoraco-lumbar dura be predicted on the basis of radiological patterns of the spinal fractures? / Acta Neurochir (Wien) 129 : 186~187

[journal] Silvestro C / 1991 / On the predictive value of radiological signs for the presence of dural lacerations related to fractures of the lower thoracic or lumbar spine / J Spinal Disord 4 : 49~53

KJCKorea
Journal Central

Journal of Korean Society of Spine Surgery 2023 KCI Impact Factor : 0.03