Short-Segment Fixation of Thoracolumbar Fractures with Incorporated Screws at the Level of Fracture

Abstract

Objective: To evaluate the effect of including the fractured vertebra in the short-segment fixation of thoracolumbar (TL) fractures.

Methods: A total of 32 patients with thoraco-lumbar fractures, selected between August 2013 and February 2016, were managed by short-segment fixation with screws at the level of the fracture, and decompression was performed only for patients with neurological deficits. The patients' functional outcome was assessed using the visual analogue scale (VAS) score for pain and the American Spinal Injury Association (ASIA) score for neurological condition. All patients were followed up with radiographs.

Results: Patients with complete neurologic deficits (n = 3) did not show any neurologic recovery. All ASIA B patients improved to ASIA C. Five ASIA C patients improved to ASIA E. The remaining five ASIA C patients improved to ASIA D. All ASIA D patients improved to ASIA B. At the final follow-up examination, the mean anterior vertebral height was 21 ± 5 mm, indicating no significant height loss during the follow-up period.

Conclusion: Short-segment fixation of TL fractures with inclusion of the fracture level into the construct offers good correction of segmental kyphosis, vertebral wedging, and vertebral height loss.

Keywords: Intermediate screw; Short-segment fixation; Thoracolumbar fracture.