Vertebral Endplate, Posterior Ligamentous Complex and Neural Dysfunction: Key Factors for Posterior Fusion Strategy in Thoracolumbar Fractures

The thoracolumbar region (T11 to L2) is more susceptible to injury than other parts of the spine, and posterior pedicle screw-based instrumentation and fusion is a widely accepted procedure to restore alignment and achieve instant and long term segmental stability of the injured spine through fusion, while the key factors determining the level of fusion remain unclear. To study the influence of vertebral endplate, Posterior Ligamentous Complex (PLC) and neural function on fusion strategy for thoracolumbar fractures via a posterior approach, a prospective study was committed. Here we report that neurological status and the integrity of the involved endplates and PLC are crucial for fusion strategy in thoracolumbar fractures. It is recommended that fusion segments are limited to the levels of the severely injured endplates and/or PLC and implantation is removed early at non fusion segments to preserve the mobility function. Mingyong Liu, Liang Zhang, Liangmin Zhang, Jianhua Zhao* and Peng Liu* Department of Spine Surgery, Daping Hospital, Third Military Medical University, China