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Abstract

BACKGROUND: Thoracolumbar fractures are traditionally treated surgically by short segment fixation; however, they may be associated with high implant failure. The insertion of an additional screw at fracture site makes it more stable with a better clinical outcome. OBJECTIVE: The aim was to evaluate the radiological and clinical parameters of posterior short segment fixation with intermediate screw implantation into the fractured vertebra. METHODS: We evaluated 30 patients with unstable thoracolumbar fractures, managed with short segment posterior instrumentation with intermediate screw in the fractured vertebra; fractures classification was done according to AOspine and TLICS systems . Eighteen male and 12 females qualified for the study; male to female ratio was 1.5:1; average age 28.86 years. Neurological status was classified according to the ASIA impairment scale. Pain was evaluated by VAS score. The percentage of vertebral body collapse and segmental kyphosis were assessed by Cobb method. Duration of follow-up lasted for 12 months. RESULTS: The mean preoperative VAS score was 8.55, had significantly improved to 0.87 at final follow up. Preoperative mean vertebral body collapse was 48.40%, which had significantly improved to 12.85% at final follow up. Mean segmental kyphotic angle was 21.83° before surgery, final mean segmental kyphosis was 8.63°. Fifteen patients with incomplete neurologic deficits had improvement by at least one ASIA grade on final follow-up observation, and 2 of 4 patients with complete neurologic deficit remained unchanged. All neurologically intact patients remained unchanged. None of patients had implant failure. CONCLUSION: Short segment fixation with intermediate screws in treatment of thoracolumbar junction fracture effectively improve stability with most of patients achieve significant improvement in clinical outcomes.

DOI

10.52573/ipmj.2020.168619

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