Short-Segment Posterior Fixation with Index Level Screws versus Long-Segment Posterior Fixation in Thoracolumbar Burst Fracture

Abstract

Background data: Posterior instrumentation of thoracolumbar burst fracture is an excellent fi xation method. Numerous methods depend on the number of fi xed vertebrae. Both short-segment fi xation, including the fractured vertebra (SSFIS), and long-segment fi xation (LSF) have been widely used with no consensus on the better method. Purpose: This study aims to compare the LSF and SSFIS in thoracolumbar spine fracture in terms of radiological and clinical outcomes. Study design: This is a prospective comparative study. Patients and methods: A total of 20 patients with thoracolumbar burst fractures were treated with posterior pedicle screw fi xation and divided into two groups, with 10 patients each, based on the number of instrumented levels: LSF group and SSFIS group. The patients were evaluated for local kyphotic angle (LKA) correction, anterior vertebral body height loss (AVHL), visual analog scale for back pain, and Oswestry disability index (ODI) for functional outcome. Results: No statistically signi fi cant differences were observed between the two groups regarding patient age, sex, reduction of visual analog scale for back pain, change in functional outcome assessed by ODI postoperatively, correction of LKA, and restoration of AVHL. However, there was a statistically signi fi cant difference favoring the SSFIS group regarding operative time, intraoperative amount of blood loss, incision length, and ODI at the 6-month follow-up. Conclusion: This data suggest that SSFIS seems comparable to LSF in managing thoracolumbar fractures resulting in adequate correction of LKA, restoration of AVHL, and preserving more motion segments.