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A Comparison of Three Different Methods of Fixation in the Management of Thoracolumbar Fractures

Pavlos Panteliadis,Omar Musbahi, BEng(Hons), MBBS,2,3 Senthil Muthian, MRCS,4 Shivam Goyal,3 Alexander Sheriff Montgomery, FRCS,4 Arun Ranganathan, FRCS4

1Department of Trauma and Orthopedics, Guy’s Hospital, Guy’s and St Thomas NHS Trust, London, England, 2Oxford University Clinical Academic Graduate School, Oxford, England, 3Bart’s and The London School of Medicine and Dentistry, Queen Mary University of London, London, England, 4Spinal Department, Royal London Hospital, Whitechapel Rd, London, England

Abstract

Introduction

Management of thoracolumbar fractures remains controversial in the literature. The primary aims of this study were to assess different levels of fixation with respect to radiological outcomes in terms of fracture reduction and future loss of correction.

Methods

This is a single center, retrospective study. Fifty-five patients presenting with thoracolumbar fractures between January 2012 and December 2015 were analyzed in the study. The levels of fixation were divided in 3 groups, 1 vertebra above and 1 below the fracture (1/1), 2 above and 2 below (2/2), and 2 above and 1 below (2/1).

Results

The most common mechanism was high fall injury and the most common vertebra L1. Burst fractures were the ones with the highest incidence. The 2/2 fixation achieved the best reduction of the fracture but with no statistical significance. The correction is maintained better by the 2/2 fixation but there is no statistical difference compared to the other fixations. Insertion of screws at the fracture level did not improve outcomes.

Conclusion

The data of this study identified a trend towards better radiological outcomes for fracture reduction and maintenance of the correction in the 2/2 fixations. However these results are not statistically significant. Future multicenter prospective clinical trials are needed in order to agree on the ideal management and method of fixation for thoracolumbar fractures.

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keywords: 
Thoracolumbar, spine, Fractures, Fixation, Surgery
Volume 11 Proof 54
doi: 
10.14444/proof54