Short segment versus long segment posterior pedicular fixation of thoracolumbar fracture

Abstract

Background: Fracture dislocation at the junction between thoracic and lumber segments of spinal column by direct or indirect high energy force which is usually managed with more than three vertebral level fixation. Short segment stabilization have a wide range of benefits including length of time utilized for surgical intervention, reduce functional and psychological disability postoperatively and local surgical site complications.
Objective: Evaluate the efficacy of posterior short segment pedicle stabilization in T-L fracture clinically and radiologically. Also to compare outcome of pedicle fixation by long segment and short segment an finally we try to insert at least one screw in the fracture vertebra to strengthen the stabilization in case of short segment stabilisation.
Patients and Method: This is a prospective study of 40 patients operated in medical city from Jan. 2013 to Dec. 2015.complaining from T-L fracture (T12, L1, L2) due to any type of trauma. A total of 17 of the patients (13 male and 4 female) underwent long segment fixation (group A) whereas 23(15 male and 8 female) of those patients have short segment fixation (group B). Long segment fixation includes two levels above and one or two level below with or without single screw placed in the vertebra that is broken. While short fixation involving vertebra above and vertebra below the fracture one.
Results: In tis prospective male commonly involved with the mean age 35-40 years in both groups, also most common involved vertebrae was 1st lumber. According to Modified Mcnab criteria, good result acquired by most of the patients, and using radiological Cobb angle evaluation significant loss of correction occur.
Conclusions: Short segment fixation in Thoracolumar region as effective as long segment. Short segment fixations are low coast with little complications at surgical site and need less blood replacement with less restriction of movement at the thoracolumbar junction.