Journal of Musculoskeletal Trauma

Original Articles

Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures: Jin Young Han, Ki Youn Kwon; J Korean Fract Soc 2020;33(1):1-8. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.1

PURPOSE
This study compared the clinical and radiological results between two groups of patients with percutaneous fixation or conventional fixation after hardware removal.
MATERIALS AND METHODS
The study analyzed 68 patients (43 open fixation and 43 percutaneous screw fixation [PSF] 25) who had undergone fixation for unstable thoracolumbar fractures. The radiologic results were obtained using the lateral radiographs taken before and after the fixation and at the time of hardware removal. The clinical results included the time of operation, blood loss, time to ambulation, duration of the hospital stay and the visual analogue scale.
RESULTS
The percutaneous pedicle screw fixation (PPSF) group showed better results than did the conventional posterior fixation (CPF) group (p<0.05) in regard to the perioperative data such as operation time, blood loss, and duration of the hospital stay. There were no significant differences in wedge angle, local kyphotic angle, and the Î”Kyphotic angle on the postoperative plane radiographs between the two groups (p>0.05). There were no significant differences in the wedge angle and local kyphotic angle after implant removal (p>0.05) between the two groups as well. However, there were significant differences in the segmental montion angle (p<0.001), and the PPSF group showed a larger segmental motion angle than did the CPF group (CPF 1.7Â°Â±1.2Â° vs PPSF 5.9Â°Â±3.2Â°, respectively).
CONCLUSION
For the treatment of unstable thoracolumbar fractures, the PPSF technique could achieve better clinical results and an improved segmental motion angle after implant removal within a year than that of the conventional fixation method.

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A Comparison of 2 Surgical Treatments for Thoracolumbar Burst Fractures: Temporary Osteosynthesis and Arthrodesis
Halil Ibrahim Süner, Rafael Luque Pérez, Daniel Garríguez-Pérez, Marta Echevarría Marín, Jose Luis Pérez, Ignacio Domínguez
World Neurosurgery.2022; 166: e419. CrossRef

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Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level: Jung Hoon Kim, Sung Soo Kim, Jin Ho Cho, Bo Hoon Jang, Jin Hwan Kim; J Korean Fract Soc 2013;26(1):21-26. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.21

Abstract PDF: 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.

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The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures: Seung Wook Baek, Kyu Dong Shim, Ye Soo Park; J Korean Fract Soc 2011;24(4):354-360. Published online October 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.4.354

Abstract PDF: PURPOSE
Evaluate the effects of sagittal imbalance on the clinical outcomes in thoracolumbar burst fractures.
MATERIALS AND METHODS
We evaluated 11 patients who had received posterior fixation for unstable burst fractures. Radiologic assessment including the compression ratio, focal kyphotic angle and sagittal balance were obtained. The clinical outcomes were assessed by ODI, VAS and SF-36. We subdivided the patients into sagittal balance and imbalance group, and compared with clinical outcomes. The relationship between radiologic and clinical outcomes was examined using correlation analysis.
RESULTS
The radiologic assessment were changed on preoperative and postoperative as follows: mean compression ratio: 15.2%, 4.9%, mean focal kyphotic angle: 43.2degrees, 20.9degrees. The mean sagittal balance was 11.5 cm. The mean score of VAS, ODI, Physical and Mental Component Summary of SF-36 were 3.7, 45.8, 43.3 and 39.8, respectively. The ODI was significantly higher in sagittal imbalance group, and SF-36 was significantly higher in sagittal balance group (p<0.05). The VAS was correlated with compression ratio and focal kyphotic angle. The ODI and Mental Component Summary of SF-36 were correlated with sagittal imbalance.
CONCLUSION
Sagittal balance effects on the functions of spine, surgical treatment should be carefully considered with unstable burst fractures.

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Treatment of Thoraco-Lumbar Bursting Fractures According to Load-Sharing Classification: Chung Hwan Kim, Jae Kwang Hwang, Young Joon Choi, Kyoung Hwan Kim, Jeong Suk Song, Jeong Ho Kang; J Korean Fract Soc 2005;18(1):69-75. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.69

Abstract PDF

PURPOSE
To determine optimal levels of posterior fixation in thoraco-lumbar bursting fractures according to the Load-sharing classification.
MATERIALS AND METHODS
From Aug. 1999 to Aug. 2003, 50 patients who had been operated with the posterior fixation in one-body thoraco-lumbar bursting fracture were selected. They were divided into two groups, group I, 6 points and below in the Load-sharing score and group II, 7 points and above. And also, each groups subdivided into two subgroups, A (short segment fixation including below and above one body) and B (long segment fixation including below and upper two body). So patients subdivided into I-A, I-B, II-A, II-B. Change of the corrected kyphotic angle was measured and compared with each subgroups.
RESULTS
The loss of the corrected kyphotic angle was measured average 1.7degrees in group I and 4.1degrees in group II, and there was significant difference between two groups (p>0.05). The loss of the corrected kyphotic angle in the subgroups was average 1.8degrees in I-A, 1.6degrees in I-B, 3.5degrees in II-A and 4.9degrees in II-B. And there was significant difference statistically in I-A and II-A (p>0.05).
CONCLUSION
In the thoraco-lumbar bursting fracture with 6 points and below of the Load-sharing score, the fixation of the short segment is a useful method. But in the fracture with 7 points and above, the fixation of the short segment is not enough, and these findings be required the further evaluation for some cause of the loss of corrected angle and treatment modalities including the fixation of the long segment.

Citations

Citations to this article as recorded by

Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations
Salman Sharif, Yousuf Shaikh, Onur Yaman, Mehmet Zileli
Neurospine.2021; 18(4): 667. CrossRef
Analysis of Factors Affecting Postoperative Loss of Reduction in Unstable Thoracolumbar Fractures
Jaewan Soh, Chang-Hwa Hong, Chung-Won Bang, Jae Chul Lee, Byung-Joon Shin
Journal of Korean Society of Spine Surgery.2017; 24(3): 190. CrossRef
Analysis of Factors Affecting Postoperative Loss of Reduction in Unstable Thoracolumbar Fractures
Jaewan Soh, Chang-Hwa Hong, Chung-Won Bang, Jae Chul Lee, Byung-Joon Shin
Journal of Korean Society of Spine Surgery.2017; 24(3): 190. CrossRef
More than 5-Year Follow-up Results of Two-Level and Three-Level Posterior Fixations of Thoracolumbar Burst Fractures with Load-Sharing Scores of Seven and Eight Points
Sub-Ri Park, Hwa-Yeop Na, Jung-Mook Kim, Dong-Chan Eun, Eui-Young Son
Clinics in Orthopedic Surgery.2016; 8(1): 71. CrossRef
The Outcomes of Short and Long Segment Posterior Instrumentation of Thoracolumbar Burst Fractures with a Load Sharing Score of 7 or More
Jeong Ho Seo, Kyu Yeol Lee
Journal of Korean Society of Spine Surgery.2015; 22(3): 92. CrossRef
Comparison of Short Segment and Long Segment Posterior Instrumentation of Thoracolumbar and Lumbar Bursting Fractures at Load Sharing Score 7 or Above
Hwa-Yeop Na, Young-Sang Lee, Joon-Cheol Choi, Woo-Seong Kim, Woo-Suk Song, Yu-Hun Jung, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo
Journal of Korean Society of Spine Surgery.2013; 20(2): 44. CrossRef
The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures
Seung-Wook Baek, Kyu-Dong Shim, Ye-Soo Park
Journal of the Korean Fracture Society.2011; 24(4): 354. CrossRef
Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level
Jeong-Gook Seo, Jong-Ho Park, Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 39. CrossRef

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