Comparison Of Effect Of Intermediate Segment And Short Segment Pedicle Screw Fixation For Surgical Treatment Of Thoracolumbar Fracture

PURPOSE: Surgical treatment in the case of thoracolumbar fracture is very controversial.Posterior fixation is most frequently used compared to the anterior fixation; however, thenumber of levels to be instrumented still remains a matter of debate. We want to compare thesurgical outcomes of short segment and intermediate segment posterior fixation forthoracolumbar burst fracture in order to provide a theoretical basis for the better treatment ofthoracolumbar burst fracture.MATERIALS and METHODS: A total of36patients who had a single level Type A-3(AO classification) burst fracture between T11to L2were selected and were managedusing posterior instrumentation and fusion, no laminectomy or discectomy procedure wasdone. They were divided into two groups as follows; Group I (n=16) included patients whowere operated by intermediate segment posterior fixation (ISPF) that is two vertebrae aboveand one vertebrae below the fracture vertebrae or one vertebrae above and two vertebraebelow the fracture level, Group II (n=20) included patients who were operated by shortsegment posterior fixation (SSPF) that is one vertebrae above and one vertebrae below thefracture vertebrae. The mean follow up period was11months ranging from6months to15months. The outcomes were analyzed in terms of Cobb’s Angle (CA), Sagittal Index (SI)and Anterior Body Height (ABH).RESULT: Both short segment and intermediate segment posterior transpedicular fixationhave good outcomes in the treatment of thoracolumbar fractures in terms of correction ofCobb’s angle, Sagittal index and Anterior body height. A statistically significant differencebetween the two study groups was noted for the immediate post op of the Cobb’s angle(p=0.031), sagittal index (p=0.048) as well as on the Cobb’s angle (p=0.024) and anteriorbody height (p=0.045) on the final follow up.CONCLUSION: Both short segment and intermediate segment posterior transpedicularfixation are able for correcting the cobb angle, sagittal index, and anterior body height;however, the intermediate segment stabilization is associated with better results as far asradiological parameters are concerned.