PURPOSE The aim of this study is to decide the optimal level of fusion with comparing the results between the short segment fusion and long segment fusion treated with pedicle screw instrumentation, including fractured vertebra in thoracolumbar junctional fractures. MATERIALS AND METHODS From February 2000 to November 2009, fifty three patients with junctional fracture of thoracolumbar spine were treated with pedicle screws and posterior fusion at our hospital. They were divided into two groups, the short segment group and long segment group. Preoperatively, immediate postoperative and last follow-up lateral radiological evaluation was done by measuring the correction and loss of segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle. In addition, operation time and amount of intraoperative bleeding were measured. RESULTS There were no significant differences of statistical analysis regarding the radiological variables between the two groups, especially the loss of corrected segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle (p>0.05). However, operative time in the short segment group (234 minutes) was shorter than the long segment group (284 minutes), and there was statistical significance (p=0.002). CONCLUSION We recommend the short segment transpediculr instrumentation one level above and one level below, including the fractured vertebra for thoracolumbar junctional fracture with 6 points or less of the load-sharing score.
PURPOSE To evaluate whether progression of compression correlates with bone densiometry index in patients who were treated conservatively for osteoporotic compression fracture of thoracolumbar spine. MATERIALS AND METHODS Using the results of bone densiometry, 30 patients who were treated conservatively for osteoporotic compression fracture of thoracolumbar spine between March 2002 to March 2005 were categorized into 4 groups; above 80%, 70 to 80%, 60 to 70%, and below 60%. We compared the measurements of sagittal index and anterior vertebral height from the plain radiographs taken at the time of injury and following three consecutive months after the injury. RESULTS Patients with lower bone densiometry index had greater amount of compression at the time of injury and more rapid progression of compression. We also found that progression of compression was lowest during the first month after injury in all groups. CONCLUSION Patients with low bone densiometry index in osteoporotic thoracolumbar compression fracture are susceptible to more rapid progression of compression and should have early brace application and longer duration of treatment for osteoporosis.
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