RT Journal Article
SR Electronic
T1 Outcomes of Thoracolumbar Fracture-Dislocation Managed by Short-Segment and Long-Segment Posterior Fixation: A Single-Center Retrospective Study
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 8006
DO 10.14444/8006
A1 Samarth Mittal
A1 Syed Ifthekar
A1 Kaustubh Ahuja
A1 Bhaskar Sarkar
A1 Gobinder Singh
A1 Arvind Rana
A1 Pankaj Kandwal
YR 2021
UL https://www.ijssurgery.com/content/early/2021/02/16/8006.abstract
AB Background Long-segment posterior fixation has been used as a mainstay treatment of spine fracture-dislocations. Studies using short-segment posterior fixation in cases of thoracolumbar fracture-dislocation are limited. We describe our experience of 26 patients with thoracolumbar fracture-dislocation treated by short-segment or long-segment posterior spinal fixation and fusion.Methods This is a single-center retrospective study of 26 patients with thoracolumbar fracture-dislocation treated by long-segment (Group 1, n = 12) and short-segment posterior instrumentation (Group 2, n = 14). Clinical (visual analog scale [VAS], Oswestry Disability Index [ODI]), neurological (American Spinal Injury Association [ASIA] scale), radiological (kyphotic angle, translational percentage, and displacement angle), and surgical (blood loss, operative time) outcomes and complications were recorded with each method. The mean follow-up period was 8.64 months (6–20 months)Results The mean duration of surgery was 3.92 ± 0.67 hours in Group 1 and 3.21 ± 0.54 hours in Group 2, and mean blood loss was 583.33 ± 111.5 mL and 478.6 ±112.2 mL in groups 1 and 2, respectively (P < .05). There was no radiologically visible pseudarthrosis, implant failure, or screw breakage in either group at follow up with no statistically significant difference between the 2 groups with regard to the radiological outcome (P > .05). Two patients in Group 1 and 6 patients in Group 2 improved after surgery at least 1 ASIA grade. VAS and ODI improved in both groups at the final follow up.Conclusions Short-segment fixation can be used for treating fracture-dislocation patients, as it results in less blood loss, decreased intraoperative time, and saves fusion segments with similar radiological and clinical outcomes as long-segment fixation.Level of Evidence 3.