Comparative study of long segment versus short segment posterior fixation of thoracolumbar fractures with pedicle screws

Vihar SJ, Naveen DS, Agrawal NK

Pdf Page Numbers :- 77-84

Vihar S Joshi¹, Naveen DS^1,*, and Nilesh Kumar Agrawal¹

¹Department of Orthopedics, Jagadguru Jayadeva Murugarajendra Medical College (JJMMC), Davanagere, Karnataka-577004, India

*Corresponding author: Dr. Naveen DS, Assistant Professor, Department of Orthopedics, Jagadguru Jayadeva Murugarajendra Medical College (JJMMC), Davanagere, Karnataka-577004, India. Mobile: +919986091144; Email: nds5959@gmail.com

Received 4 February 2021; Revised 16 March 2021; Accepted 22 March 2021; Published 31 March 2021

Citation: Vihar SJ, Naveen DS, Agrawal NK. Comparative study of long segment versus short segment posterior fixation of thoracolumbar fractures with pedicle screws. J Med Sci Res. 2021; 9(2):77-84. DOI: http://dx.doi.org/10.17727/JMSR.2021/9-12

Copyright: © 2021 Vihar SJ et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PDF

Abstract

Choice of long or short segment fixation for thoracolumbar fractures, benefits of either of these techniques has been a topic for analysis and assessment. Kyphotic angles in twenty patients diagnosed to have thoracolumbar vertebral fractures between December 2019 to December 2020 in Bapuji hospital and Chigateri general hospital, Davanagere, Karnataka, India were measured pre operatively, post operatively and at one year follow up and assessed. No statistical difference between the degrees of correction of initial kyphotic angle between long segment fixation and short segment posterior fixation in our study was found (p<0.6). Method of fixation of the thoracolumbar vertebral fracture did not correlate with initial degree of kyphosis (p=0.4). Amount of correction loss at one year follow up was found to be statistically significant in short segment fixation (p<0.05). Loss of kyphotic angle at one year follow up was higher in case of short segment fixation than long segment fixation and found to be statistically significant (p<0.005). Our study showed that long segment fixation helps in better correction of the kyphosis angle with lesser chance of loss of correction and can be opted when pedicles aren’t intact at the fracture level, as in cases of burst fractures. Short segment fixation provides better rigid fixation at the site of fracture with increased range of motion at the thoracolumbar segment and can be treatment of choice when the pedicles at the fractured level are intact, as in cases of compression fractures, having benefits of shorter duration of surgery and reduced risks.

Keywords: thoracolumbar fractures; long segment posterior; short segment posterior; pedicle screw; posterior spine