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

作     者：Dinesh Kumer B.K 

作者单位：吉林大学 

学位级别：硕士

导师姓名：Wang Jin Cheng

授予年度：2012年

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

摘      要：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.