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Should the level of the posterior instrumentation combined with the intermediate screw be a short segment or a long segment in thoracolumbar fractures with fusion to the fractured segment?

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Abstract

Purpose

It was aimed to compare the results of long segment posterior instrumentation with intermediate pedicular screw + fusion at the level of the fractured segment including one vertebra above and one below the fractured vertebra (LSPI) and short segment posterior instrumentation with intermediate pedicular screw + fusion at the level of the fractured segment including one vertebra above and one below the fractured vertebra (SSPI) in the surgical treatment of thoracolumbar vertebral fractures.

Methods

Ninety patients with thoracolumbar vertebral (T11-L2) fractures operated between March 2015 and February 2022 were included in this retrospective study. The patients were divided into two groups as those who underwent LSPI (n, 54; age, 40.3) and those who underwent SSPI (n, 36; age, 39.7). Radiological evaluations like vertebral compression angle (VCA), vertebral corpus heights (VCH), intraoperative parameters, and complications were compared between the groups.

Results

Correction in early postoperative VCA was statistically significantly better in LSPI (p = 0.003). At 1-year follow-up, postoperative VCA correction was significantly more successful in LSPI (p = 0.001). There was no difference between the two groups in terms of correction loss in VCA measured at 1-year follow-up. There was no statistically significant difference between the two groups in terms of postoperative VCH, VCH at 1-year follow-up, and correction loss in VCH.

Conclusion

LSPI provides better postoperative kyphosis correction of the fractured vertebra than SSPI. Regarding the segment level of posterior instrumentation, there was no difference between the two groups in terms of the loss of achieved correction of VCA, ABH, and PBH at 1-year follow-up. Operating a thoracolumbar fracture with LSPI will lengthen the operation and increase the number of intraoperative fluoroscopies compared to SSPI.

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Data availability

No datasets were generated or analysed during the current study.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey

    Onur Suer

  2. Department of Orthopaedics Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Selahaddin Aydemir & Omer Akcali

  3. Department of Orthopaedics Surgery, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey

    Bunyamin Kilicli & Anil Murat Ozturk

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  1. Onur Suer
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Contributions

Concept: O.S., O.A., A.M.O.

Design: O.S., S.A., B.K., A.M.O.

Supervision: O.S., O.A., A.M.O.

Materials: O.S., S.A., B.K., A.M.O.

Data Collection and/or Processing: O.S., S.A., B.K., A.M.O.

Analysis and/or Interpretation: O.S, O.A., A.M.O.

Literature Search: All authors.

Writing: All Authors.

Critical Review: O.S., O.A., A.M.O.

Corresponding author

Correspondence to Anil Murat Ozturk.

Ethics declarations

Our study was accepted as an oral presentation at the 31st National Turkish Orthopedics and Traumatology Congress (25–30 October 2022, Antalya, Turkey) and was published in the congress book. This internet address belongs to the congress oral presentation book (https://www.totbid.org.tr/uploads/31.totbid_kongre_program.pdf). This study has not been published in any journal.

IRB approval

This study was approved by Medical Research Ethics Committee of Ege University (23-1T12).

Competing interests

The authors declare no competing interests.

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Level of clinical evidence: 3

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Suer, O., Aydemir, S., Kilicli, B. et al. Should the level of the posterior instrumentation combined with the intermediate screw be a short segment or a long segment in thoracolumbar fractures with fusion to the fractured segment?. Eur J Trauma Emerg Surg (2024). https://doi.org/10.1007/s00068-024-02518-7

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