Treatment Results of Unstable Thoracolumbar Fractures with Surgical Technique of Short Segment Fixation

Thoracolumbar junction (T11 to L1) is the most common site of spine fractures. Surgery of these fractures is performed by using long and short segment methods and each of them has its own advantages and disadvantages. In addition to these methods, the modified short segment method that includes the placement of pedicular screw in fractured vertebra and two intact adjacent vertebrae has been presented but its success rate has not been clearly established yet. The aim of this study was to evaluate the efficiency of modified short segment method in the treatment of unstable thoracolumbar junction fractures. This cross-sectional study was conducted on 50 patients with unstable thoracolumbar fractures who underwent the surgery with modified short segment method (insertion the pedicular screw in fractured vertebra and the below and above of it) in the neurosurgical department of Uremia Imam Khomeini Hospital during 3 years. Evaluating the efficiency of surgery in patients was performed by comparing the kyphotic deformity (Cobb method) and the pain intensity (visual analogue scale) before, immediately and 12 months after the surgery. A total of 50 patients, 28(56%) and 22(44%) persons were male and female, respectively. The mean age of patients was 46±17.3 (19-72 years). The mean of kyphosis was 28.3±6.4 degrees preoperatively which became 5.4±3.6 degrees (p<0.001) in immediate postoperation and 7.4±5.8 degrees (p<0.01) at final follow-up. The mean of visual analogue scale was 8±1.4 preoperatively and became 4±2.7 after surgery and at final follow-up was 2±0.7 (p<0.05). The results showed that the surgery with modified short segment fixation technique using pedicular screw in fractured vertebra is an effective method for treatment of unstable thoracolumbar fractures.