Clinical Outcomes of Short Same-segment Fixation in Thoracolumbar Junction Fractures | Chapter 4 | New Frontiers in Medicine and Medical Research Vol. 16

Short same-segment posterior fixation reduces the number of vertebral levels involved in mending a spine fracture (SSPF). Short same-segment posterior fixation with pedicle fixation at the fracture level has biomechanical benefits for kyphosis correction maintenance, lowering failure rates, enhancing spinal motion, and allowing for early rehabilitation [1-4].

Materials and Procedures: All patients with thoracolumbar junction fractures in our study were evaluated using biomechanical criteria and clinical outcomes between 2014 and 2016. By employing Cobb's technique to measure the kyphotic angle, the immediate postoperative radiographs were compared to follow-up radiographs to determine any loss of correction. At each follow-up, the clinical outcome was evaluated using the Oswestry disability score. The intraobserver and interobserver reliability were explored.

From 2014 to 2016, 35 patients with unstable thoracolumbar fractures had surgery with a posterior spinal fixation system and pedicle screw insertion at the level of the damaged vertebrae. It took an average of 18 months between visits. The typical preoperative kyphotic angle was 17.2°, which improved to 5.9° immediately after surgery, resulting in a 65 percent correction on average. At the final follow-up, the average postoperative Cobb's angle was 7.7°, keeping a 55 percent correction. At the ultimate follow-up, disability has decreased from 78 percent preoperatively to 47.27 percent postoperatively.

Conclusion: Short same-segment posterior fixation has a decreased implantation failure rate and greater biomechanical stability when compared to standard SSPF; nevertheless, long-term kyphosis correction was not maintained to the same degree, which was statistically insignificant. Long-term clinical pain and disability improved despite the lack of kyphosis correction. According to this study, SSPF reduces implantation failure and reoperation rates while also providing stronger biomechanical benefits.

Author (S) Details

Shubham Jain
Department of Orthopedics, B. J. Medical College Ahmedabad, Gujarat, India.

Piyush Mittal
Department of Orthopedics, B. J. Medical College Ahmedabad, Gujarat, India.

Amit Kumar
Department of Orthopedics, B. J. Medical College Ahmedabad, Gujarat, India.

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