Journal of Musculoskeletal Trauma

Original Articles

Short Segment Fixation of Flexion-Distraction Injuries in Thoracolumbar Spines: Young Do Koh, Jeong Joon Lee, Jong Kyong Ha; J Korean Fract Soc 2005;18(4):452-458. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.452

Abstract PDF: PURPOSE
To evaluate the efficacy of short segment fixation in flexion-distraction injuries of thoracolumbar junction.
MATERIALS AND METHODS
Twenty-five patients with a flexion-distraction injury in thoracolumbar junction confirmed by radiogram or MRI and stabilized with a short construct spanning short segment were included in this study. We investigated the location of fractures, type of fractures, anterior or posterior vertebral body height, and preoperative and postoperative kyphotic angle of injuried motion-segments on radiologic examinations and clinical outcome on the Oswestry score.
RESULTS
A significant correction of deformity was achieved, from a mean preoperative kyphosis of 17.3 degrees to a mean postoperative kyphosis of 8.4 degrees. The loss of correction were minimal. The mean Oswestry score was 6.9, with 84% of patients having minimal disability (<20%) and no correlation with age, sex, the location of fractures, type of fractures, change of kyphotic angle.
CONCLUSION
This study demonstrates the efficacy of posterior open reduction and short segment fixation of flexion-distraction injuries.

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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

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
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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Posterior Short Segment Instreumntation and Fusion for the Unstable Thoracolumbar Spine Fracture: A Comparative Study: Ki Tack Kim, Gyu Pyo Hong, Dae Woo Hwang, Sang Un Lee, Sang Wook Bae; J Korean Soc Fract 2000;13(2):352-360. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.352

Abstract PDF: INTRODUCTION : In treating of acute unstable thoracolumbar spine fractures, current trend is a toward short segment instrumentation to spare the motion segments. Many authors reported the result of short instrumentation and fusion, but there have been few reports about the effect of additional screw fixation at fractured vertebra in posterior short segment instrumentation and fusion. Therefore, the objective of this study is to compare the results of treatment between with/without screw fixation at the fractured vertebra in posterior short segment pedicle screw fixation. MATERIAL AND METHODS : Twenty-three patients with unstable thoracolumbar spine fractures were treated with posterior short segment instrumentation and fusion. Eleven cases classified into group A were not fixed at the fractured vertebre. They were followed up to average 45 months(24-79). Twelve cases classified into group B were treated with screw fixation at the injured vertebra and followed up to average 38 months(14-78). Authors evaluated the radiologic assessment, such as wedge angle of fractured body, local kyphotic angle and wedge index(the ratio of anterior body height to posterior body height), the neurologic assessment by Frankel grade system and functional assessment by Denis system.
RESULTS
: There was no complication resulted from additional pedicle screw fixation at fractured level. In rediologic assessment, wedge angle were measured at preoperative, postoperative and last follow-up time as follows; in group A, 22.2degrees -11.3degrees -14.1degrees and in group B, 19.5degrees -8.8degrees -9.8degrees . The local kyphotic angle measured were 17.9degrees -7.0degrees -14degrees in group A and 17.1degrees -6.3degrees -7.9degrees in group B. The wedge index were 42.9%-22.6%-28.5% in group A and 40%-19.5%-22.4% in group B. At last follow-up time, eight eases showed Frankel grade E and three cases showed grade D in group A, and all cases of group B were Frankel E. Denis pain score were satisfctory in all of both group and Denis work score were also satisfactory in two group except one case of group A.
CONCLUSIONS
: Additional screw fixation at fractured verteba did not cause any complication. There was no significant difference in reduction rate between two groups(P>0.05), but group B showed better maintenance of correction of kyphotic deformity than that of group A(P<0.05). In conclusion, it seems that additional screw fixation at fractured level may be better method in maintaining asgittal alignment and decreasing the risk collapsing of body.

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