The impact of fixed segment length on the surgical outcomes of single-segment lumbar burst fractures: shorter segments are more prone to the formation of local stable osteophytes: a retrospective observational study.

Abstract

Study design: Retrospective observational study.

Purpose: This study investigated the impact of long-segment and short-segment pedicle screw fixation on degeneration indicators, particularly stable osteophytes, in the treatment of single-segment lumbar burst fractures.

Overview of literature: Current research mainly focuses on clinical indicators such as operation time, Visual Analog Scale (VAS) pain scores, and imaging indicators like the Cobb angle correction rate. However, there is a paucity of research on the indicators of intervertebral disc degeneration at fixed segments (such as bone spur formation, vacuum phenomenon in the disc, and Modic changes). As the health status of the intervertebral disc is closely related to spinal stability, this study provides a comprehensive evaluation of the efficacy of two surgical techniques, providing a more precise basis for clinical treatment.

Methods: This was a retrospective analysis of a cohort of 64 patients with single-segment lumbar burst fractures. Among them, 38 patients underwent posterior long-segment pedicle screw-rod fixation (long-segment group), while 26 cases received posterior shortsegment pedicle screw fixation (short-segment group). Changes in degeneration indicators within the fixation area, including osteophyte formation, intervertebral disc vacuum sign, and intervertebral height, were examined.

Results: All 64 patients completed surgery and were followed up for at least 24 months. At the final follow-up at 24 months, the shortsegment fixation group exhibited a higher osteophyte formation score than the long-segment fixation group. However, no significant between-group differences were observed in the incidence of intervertebral disc vacuum sign or intervertebral height loss rate.

Conclusions: After a 2-year follow-up, the short-segment fixation group demonstrated a similar intervertebral height loss rate and intervertebral disc vacuum sign incidence compared to the long-segment fixation group, but a higher rate of stable osteophyte formation.