Comparison of Short Segment Percutaneous Transpedicular Fixation With and Without Inclusion of Fractured Vertebrae in Thoracolumbar Fractures

Abstract

Objective:  To compare the outcome of SSPF (Short Segment Posterior Fixation) with and without the inclusion of fractured vertebrae in thoracolumbar fractures in terms of visual analog score and vertebral column stability. Materials and Methods:  The study enrolled 96 patients who were divided into two groups. Group A treated by SSPF (four screws: one level above and below the fracture), and Group B was treated by PSFFV (six screws: including fractured vertebrae). Assessment of parameters related to clinical and radiological aspects was recorded at 3 – 6 months. Results:  Mean ages of patients were 36.96 and 37.41 years with an M:F ratio of 1.8:1 and 1.4:1 in groups A (SSPF) and B (PSFFV), respectively. Mean VAS preoperatively, and postoperatively, at 3 and 6 months were 8.78 vs. 9.01, 4.98 vs. 5.01, 2.08 vs. 2.11, and 0.47 vs. 0.67 in groups A and B, respectively. Mean Kyphotic angle preoperatively, postoperatively, at 3 and 6 months were 21.76 vs. 22.91, 11.13 vs. 10.16, 13.59vs. 11.16 and 14.88 vs. 12.87 in groups A and B respectively. Mean AVH preoperatively, and postoperatively, at 3 and 6 months were 19.11 vs. 18.72, 20.01 vs. 22.71, 20.61 vs. 22.87, and 20.02 vs. 22.67 in groups A and B, respectively. Conclusion:  The results of this study favor PSFFV (Group B) over SSPF (Group A) in terms of vertebral column stability which was better achieved in PSFFV. PSFFV was also found superior with no implant failure which declares it safer and more effective than SSPF. None of the techniques was found superior in terms of pain. Radiologically, PSFFV, showed significant improvement in achieving anterior vertebral height, while there was no important distinction in kyphotic angle between the two.