Comparative study between a short segment with incorporating screws versus long-segment pedicle-screw fixation in management of unstable thoracolumbar spine fractures

Abstract

Background Posterior pedicle screw fixation has become a popular method for treating thoracolumbar burst fractures. However, it remains unclear whether additional fixation of more segments could improve clinical and radiological outcomes. Aim and objectives The aim of this study was to evaluate the clinical and radiological outcome of a short segment with incorporating screws versus long-segment posterior stabilization using transpedicular screws for management of unstable thoracolumbar spine fractures. Patients and methods This was a prospective retrospective comparative clinical trial with 20 patients’ short segment with incorporating screws and long-segment fixation in another 20 patients. The duration of the study ranged from 6 to 12 months. Results There is a significant difference between the two studied groups as regards angle correction; however, there is a significant reduction in angle correction in both groups: group A more than group B, and there is a significant difference between the two studied groups regarding complications that were more frequent in group B. Conclusion Short-segment fixation (including the fractured vertebrae) in the thoracolumbar region is as effective as the long segment with good spinal canal restoration and correction of kyphotic angle and may enhance the regaining of neurological function although better results were achieved radiologically by long-segment fixation while clinically they are the same results.