Open reduction of thoraco-lumbar fractures and sagital balance correction using Schanz screws

Abstract

Introduction: The correction of thoracic and lumbar spine fractures with a short instrumentation using Schanz screws, is an effective method for stabilization and sagittal balance restoration.

Materials and methods: Bidirectional observational study, included patients undergoing arthrodesis with Schanz screws to manage thoracic and lumbar fractures, the general characteristics, type, and location of the fracture, besides the gain in height of the vertebral body and segmental angle were analyzed. before and after surgery. Clinical and imaging control was performed postoperatively and 1 month after this. p-value < .05 was statistically significant.

Results: Of 35 patients undergoing arthrodesis, 13 were excluded due to the absence of images and follow-up. There was a higher proportion of men, the main location of the fracture and AO spine classification was in T12 and type A4/B1 respectively, there was no intraoperative complication, no transfusion was required, and a short hospital stay. A mild complication was presented in the follow-up. The average pre and postoperative change was 12 degrees in the Cobb angle and 5.2 mm vertebral body height in the fractured vertebra, these changes were statistically significant.

Conclusion: Thoracolumbar and lumbar spine fracture correction with short segment fixation using Schanz screws, is an effective, safe and fast, showing significantly vertebral height gain and segmental angle correction, as a consequence, a correction of the balance and alignment of the spine.

Keywords: Arthrodesis; Artrodesis; Cobb angle; Fractura espinal; Fusión espinal; Spinal Fracture; Spinal fusion; Ángulo Cobb.