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Comparison of Surgical Outcomes in Thoracolumbar Fractures Operated with Varying Lengths of Posterior Constructs-Short Segment Versus Long Segment Fixation

Comparison of Surgical Outcomes in Thoracolumbar Fractures O...

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作者： Dinesh Kumer B.K 吉林大学

学位级别：硕士

Objective: Surgical treatment of thoracolumbar fractures is very controversial. The optimalgoals of surgical treatment in thoracolumbar burst fractures are decompression of neural element,restoration of vertebral height and alignment, stabilization, decrease deformity and earlymobilization in order to acquire maximal recovery from neurological and functional *** general agreement on the goals of surgical treatment, considerable controversy anddebates exist in the choice of operative techniques. It is clear that the operative managementwith internal fixation has known advantages of stability, early mobilization and rehabilitation,neurological improvement, spinal alignment and decreased deformity. Posterior instrumentationtechnique is most frequently practiced;however, the number of levels to be instrumented stillremains a matter of debate and disagreement. We want to compare the surgical outcomes ofshort segment and long segment posterior fixation for thoracolumbar burst fractures in order toprovide a theoretical basis for the better treatment of thoracolumbar fractures. Method: From Sept.2008to April2011, a total of39patients who had a single levelthoracolumbar burst fracture between T10to L3and classified as a burst fracture according toMcAfee classification or type A3fracture according to AO/Magerl classification were *** patients were managed by posterior instrumentation alone. The patient’s case notes,operation records, pre-op, post-op and follow up radiographs were reviewed. Patients weredivided into2groups depending upon the number and level of vertebra instrumented. Group Icomprised of24patients operated by short segment posterior fixation （SSPF）, i.e;one vertebracephalad and one caudad to the fractured vertebra and Group II comprised of15patientsoperated by long segment posterior fixation （LSPF）, i.e;two vertebrae cephalad and two caudadto the fractured vertebra. The mean follow up period was13.2months ranging from8months to19months.

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Comparison of Effect of Intermediate Segment and Short Segment Pedicle Screw Fixation for Surgical Treatment of Thoracolumbar Fracture

Comparison of Effect of Intermediate Segment and Short Segme...

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作者： Samir Karki 吉林大学

学位级别：硕士

PURPOSE: Surgical treatment in the case of thoracolumbar fracture is very *** fixation is most frequently used compared to the anterior fixation;however, thenumber of levels to be instrumented still remains a matter of debate. We want to compare thesurgical outcomes of short segment and intermediate segment posterior fixation forthoracolumbar burst fracture in order to provide a theoretical basis for the better treatment ofthoracolumbar burst fracture.MATERIALS and METHODS: A total of36patients who had a single level Type A-3(AO classification) burst fracture between T11to L2were selected and were managedusing posterior instrumentation and fusion, no laminectomy or discectomy procedure wasdone. They were divided into two groups as follows;Group I (n=16) included patients whowere operated by intermediate segment posterior fixation (ISPF) that is two vertebrae aboveand one vertebrae below the fracture vertebrae or one vertebrae above and two vertebraebelow the fracture level, Group II (n=20) included patients who were operated by shortsegment posterior fixation (SSPF) that is one vertebrae above and one vertebrae below thefracture vertebrae. The mean follow up period was11months ranging from6months to15months. The outcomes were analyzed in terms of Cobb’s Angle (CA), Sagittal Index (SI)and Anterior Body Height (ABH).RESULT: Both short segment and intermediate segment posterior transpedicular fixationhave good outcomes in the treatment of thoracolumbar fractures in terms of correction ofCobb’s angle, Sagittal index and Anterior body height. A statistically significant differencebetween the two study groups was noted for the immediate post op of the Cobb’s angle(p=0.031), sagittal index (p=0.048) as well as on the Cobb’s angle (p=0.024) and anteriorbody height (p=0.045) on the final follow up.CONCLUSION: Both short segment and intermediate segment posterior transpedicularfixation are able for correcting the cobb angle, sagittal index, and

关键词： Thoracolumbar burst fracture posterior instrumentation intermediatesegment fixation short segment fixation

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