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European Spine Journal

, Volume 19, Issue 10, pp 1651–1656 | Cite as

Inclusion of the fracture level in short segment fixation of thoracolumbar fractures

  • Majid-Reza Farrokhi
  • Ali Razmkon
  • Zohreh Maghami
  • Zahra Nikoo
Original Article

Abstract

Short segment posterior fixation is the preferred method for stabilizing thoracolumbar fractures. In case of significant disruption of the anterior column, the simple short segment construct does not ensure adequate stability. In this study, we tried to evaluate the effect of inclusion of the fractured vertebra in short segment fixation of thoracolumbar fractures. In a prospective randomized study, eighty patients with thoracolumbar fractures treated just with posterior pedicular fixation were randomized into two groups receiving either the one level above and one level below excluding the fracture level (bridging group), or including the fracture level (including group). Different clinical and radiological parameters were recorded and followed. A sum of 80 patients (42 patients in group 1 and 38 patients in group 2) were enrolled in the study. The patients in both the groups showed similar clinical outcome. There was a high rate of instrumentation failure in the “bridging” group. The “bridging” group showed a mean worsening (29%) in kyphosis, whereas the “including” group improved significantly by a mean of 6%. The significant effect of the “including” technique on the reduction of kyphotic deformity was most prominent in type C fractures. In conclusion, inclusion of the fracture level into the construct offers a better kyphosis correction, in addition to fewer instrument failures, without additional complications, and with a comparable-if not better-clinical and functional outcome. We recommend insertion of screws into pedicles of the fractured thoracolumbar vertebra when considering a short segment posterior fixation, especially in Magerl type C fractures.

Keywords

Thoracolumbar instrumentation Short segment Including Pedicular fixation Fracture level 

Notes

Conflict of interest statement

We do not have any financial relationships with the organization that sponsored the research.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Majid-Reza Farrokhi
    • 1
  • Ali Razmkon
    • 1
  • Zohreh Maghami
    • 1
  • Zahra Nikoo
    • 1
  1. 1.Shiraz Neurosciences Research Center, Department of NeurosurgeryShiraz University of Medical SciencesShirazIran

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