Long-term radiological outcomes of short-segment stabilization in thoracic burst fracture

Abstract

Introduction: Short-segment (SS) transpedicular instrumentation and distraction have been used as a popular method recently due to the kyphotic angulation and adequate spinal canal decompression provided by the fusion of fewer mobile vertebra segments. This study aims to demonstrate that adequate decompression of spinal canal and kyphosis angulation can be improved by SS instrumentation and distraction in thoracic vertebrae burst fracture. Methods: Patients who were admitted to our clinic for thoracic vertebra burst fractures between 2014 and 2017 and who underwent fusion with transpedicular screws were retrospectively analyzed. Results: Both the sagittal index (SI) and canal occupation rates (COR) showed statistically significant changes between the pre-operative and early post-operative periods (pSI=0.001, pCOR=0.001). Evaluation results of the patients at 2-year follow-up; mean SI was 16.2°±1.25° and the mean COR was 6.25±2.4%. There was no statistically significant difference between both SI and CORs postoperatively and after 2 years of follow-up (pSI=0.916, pCOR=0.565). Discussion and Conclusion: We believe that SS stabilization is sufficient especially in patients with COR <40%, SI <25°, American Spinal Injury Association score E, and preserved posterior elements of the vertebra.