Short-segment posterior fixation with index level screws versus long-segment posterior fixation for thoracolumbar spine fracture: angle of correction and pain

Abstract Background Thoracic and lumbar fractures represent nearly 90% of traumatic spine injuries. Thoracolumbar region is susceptible to injury because of its location between the stiff kyphotic thoracic spine and the mobile lordotic lumbar region. To compare between short-segment fixation with sc...

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Bibliographic Details
Main Authors: Ahmed M. Sallam, Walid A. Abdel Ghany, Ali Kotb Ali, Mohamed A. Habib, Ahmed F. Toubar, Mohamed S. Kabil, Ahmed Abdel Barr Salem, Sherif H. Abouzeid Mourad, Mohamed A. Nada
Format: Article
Language:English
Published: SpringerOpen 2018-07-01
Series:Egyptian Journal of Neurosurgery
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Online Access:http://link.springer.com/article/10.1186/s41984-018-0012-9
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Summary:Abstract Background Thoracic and lumbar fractures represent nearly 90% of traumatic spine injuries. Thoracolumbar region is susceptible to injury because of its location between the stiff kyphotic thoracic spine and the mobile lordotic lumbar region. To compare between short-segment fixation with screws into index level and long-segment fixation in maintaining angle of correction and pain. Methods A prospective study included 91 patients, who had single-level thoracolumbar fracture with Cobb’s angle ≤ 25° and underwent posterior fixation. Forty-four patients underwent short-segment fixation with screws into the index level, and 47 patients underwent long-segment fixation with skipped index level. The angle of correction, pain, and neurological state were regularly assessed. Results Forty-four patients (48.35%) had short segment and 47 (51.65%) had long-segment fixation. In the short segment group, the pre-operative mean Cobb’s angle was 19.34° ± 3.63° and the angle of correction was 8.14° ± 1.9° after 1 year, while in the long segment group, the pre-operative mean Cobb’s angle was 19.08° ± 4.0° and the angle of correction was 8.62° ± 2.59°. Regarding pain, in the short segment group, the pre-operative visual analogue scale (VAS) was 5.59 ± 2.09 that was reduced to 1.39 ± 0.58 at the 1 year follow-up, while the long segment group VAS was 5.4 ± 2.01 pre-operatively that was reduced to 1.47 ± 0.58. Conclusions Short-segment fixation can maintain the angle of correction as long-segment fixation for single level thoracolumbar traumatic fracture with lower complication and faster pain relief. Trial registration Clinicaltrials.gov/NCT03272243. Registered: 1 September 2017.
ISSN:2520-8225