Short segment versus long segment pedicle screws fixation in management of thoracolumbar burst fractures

https://doi.org/10.53730/ijhs.v6nS6.11712

Authors

  • Shehab El-Khadarway Prοfessοr οf Neurosurgery Department, Faculty οf Medicine– Al-Azhar University, Egypt
  • Adel Ragab Prοfessοr οf Neurosurgery Department, Faculty οf Medicine– Al-Azhar University, Egypt
  • Massoud Mahmoud Mostafa Resident of Neurosurgery, EL-Ahrar Teaching Hospitals, Egypt

Keywords:

thoracolumbar burst fracture, long-segment, pedicle screw fixation, short-segment, 3D screw

Abstract

Background: Selection of stabilization procedures for treating thoracolumbar burst fractures remains controversial. Both long-segment and short-segment pedicle screw fixation have been used widely with no consensus on the better method. Aim of study: To compare the outcome of long segment and short segment posterior fixation as amanagement of thoracolumbar burst fractures. Patients and Methods: 60 patients fulfilling the inclusion criteria who underwent posterior pedicle screw fixation for burst fracture of thoracolumbar spine in Neurosurgery Department of Al-Azhar University Hospitals and El-Ahrar General Hospital, Zagazig between August 2019 and Febrauray 2022. Patients were randomized into one of two groups. Short segment group (30 patients) was treated by short segment fixation, i.e., 1 level above and 1 level below the fractured vertebra. Long segment group (30 patients) was treated by long segment pedicle screw fixation, i.e., fixation of 2 levels above and below the fractured vertebra. Assessment of kyphosis correction by using the Cobb method and restoration of the anterior vertebral body height was performed radiologically postoperatively and at 3 and 6 months follow up. Results: Demographic data of both groups were quite comparable. thoracolumbar burst fracture

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References

Alhemiary HA and Almayoof DF. Short segment versus long segment posterior pedicular fixation of thoracolumbar fracture. Fac Med Baghdad 2017; Vol.59, No.3 : 204-209.

Aly TA. Short segment versus long segment pedicle screws fixation in management of thoracolumbar burst fractures: meta-analysis. Asian Spine J. 2017;11:150–60.

Aoui M, Nizar Sahnoun, Mohamed Abid, Mahdi Maatoug, Majdi Hsairi, Yosr Hentati, Hassib Keskes. Posterior short segment pedicle screw fixation for the treatment of thoracolumbar fracture. Pan African Medical Journal. 2020;35:102.

Biakto KT, M. Andry Usman, W. Limoa et al. Comparison between short segment pedicle screw fixation and long segment pedicle screw fixation for treatment of neglected single level thoracolumbar burst fracture. International Journal of Surgery Open 26 (2020) 145e149

El-Sharkawi MM, Mohamed MA,, El Sabrout AA, Hassan MG. Short Versus Long Segment Fixation for Thoracolumbar Burst Fractures: A Randomized Controlled Trial. Egy Spine J 24:6-13, 2017.

Gandamayu, I. B. M., Antari, N. W. S., & Strisanti, I. A. S. (2022). The level of community compliance in implementing health protocols to prevent the spread of COVID-19. International Journal of Health & Medical Sciences, 5(2), 177-182. https://doi.org/10.21744/ijhms.v5n2.1897

Hao D, Wang W, Duan K, Ma M, Jiang Y, Liu T, et al. TwoYear Follow-up Evaluation of Surgical Treatment for Thoracolumbar Fracture-Dislocation. Spine. 2014;39(21):E1284–E1290.

Hur JW, Rhee JJ, Lee JW, Lee HK. A comparative analysis of the efficacy of short-segment pedicle screw fixation with that of long-segment pedicle screw fixation for unstable thoracolumbar spinal burst fractures. Clin Med Res. 2015;4:1-5.

Jo, DJ.; Kim, Y.-S.; Kim, S.-M.; Kim, K.-T.; Seo, E.-M. Clinical and radiological outcomes of modified posterior closing wedge osteotomy for the treatment of posttraumatic thoracolumbar kyphosis. J. Neurosurg. Spine 2015, 23, 510–517.

Korkmaz, M.; Akgul, T.; Ozkunt, O.; Sariyilmaz, K.; Vallyev, N.; Dikici, F. Short-segment pedicle screw fixation including pedicle screw at the fractured level for treatment of unstable thoracolumbar fractures. J. Turk. Spinal Surg. 2015, 26, 19–25.

Kurd MF, Krystal JD: Thoracolumbar trauma. Orthopaedic Knowledge Update 12. Wolters Kluwer, the Netherlands; 2018. 609-618.

Necdet S, Selman D, Cagri O, Ismail T. Comparison of four different posterior screw fixation techniques for the treatment of thoracolumbar junction fractures. World Neurosurgery 2019:E1e8.

Okten, A.I.; Gezercan, Y.; Özsoy, K.M.; Ates, T.; Menekse, G.; Aslan, A.; Cetinalp, E.; Guzel, A. Results of treatment of unstable thoracolumbar burst fractures using pedicle instrumentation with and without fracture-level screws. Acta Neurochir. 2015, 157, 831–836.

Salama SMM, Hesham M. Elsaady Farhoud, Hassan F. Elbehairy. Comparative study between a short segment with incorporating screws versus long-segment pedicle-screw fixation in management of unstable thoracolumbar spine fractures. Sci J Al-Azhar Med Fac, Girls 2021 5:685–689

Sapkas G, Kateros K, Papadakis SA, Brilakis E, Macheras G, Katonis P. Treatment of unstable thoracolumbar burst fractures by indirect reduction and posterior stabilization: short-segment versus long-segment stabilization. Open Orthop J. 15 janv 2010; 4:7-13.

Shim, J.-H.; Seo, E.-M. Efficacy and Radiographic Analysis of Minimally Invasive Posterior Mono-Axial Pedicle Screw Fixation in Treating Thoracolumbar Burst Fractures. J. Clin. Med. 2022, 11, 516.

Singh A, Bali SK, Maji S, Ahuja K, Moger NM, Mittal S, Sarkar B, Kandwal P. Short Segment Versus Long Segment Posterior Pedicle Screws Fixation for Treatment of Thoracolumbar Burst Fracture: A Comparative Prospective Study. Asian J. Med. Res. 2020;9(2):1-6.

Smith C J, Abdulazeez M M, Elgawady M, et al. (2021): The Effect of Thoracolumbar Injury Classification in the Clinical Outcome of Operative and Non-Operative Treatments. Cureus 13(1): e12428.

Steib J-P, Aoui M, Mitulescu A, Bogorin I, Chiffolot X, Cognet JM et al. Thoracolumbar fractures surgically treated by « in situ contouring ». Eur Spine J. 2006 Dec;15(12):1823-32.

Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). The COVID-19 pandemic. International Journal of Health Sciences, 5(2), vi-ix. https://doi.org/10.53730/ijhs.v5n2.2937

Tezeren G, Kuru I. Posterior fixation of thoracolumbar burst fracture: short-segment pedicle fixation versus long-segment instrumentation. J Spinal Disord Tech. 2005;18:485–488.

Toyone T, Ozawa T, Inada K et al. Short-segment fixation without fusion for thoracolumbar burst fractures with neurological deficit can preserve thoracolumbar motion without resulting in post-traumatic disc degeneration: a 10-year follow-up study. Spine. (Phila Pa 1976) 38: 1482-1490, 2013.

Ye C, Luo Z, Yu X, et al. Comparing the efficacy of short-segment pedicle screw instrumentation with and without intermediate screws for treating unstable thoracolumbar fractures. Medicine (Baltimore) 2017;96:e7893.

Yildizhan, S.; Boyaci, M.G.; Karavelioglu, E.; Aslan, A.; Karabekir, H.S. Spinal trauma classification and principles of treatment: A retrospective study of 234 cases. J. Turk. Spinal Surg. 2015, 26, 27–36.

Published

12-08-2022

How to Cite

El-Khadarway, S., Ragab, A., & Mostafa, M. M. (2022). Short segment versus long segment pedicle screws fixation in management of thoracolumbar burst fractures. International Journal of Health Sciences, 6(S6), 5216–5230. https://doi.org/10.53730/ijhs.v6nS6.11712

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Section

Peer Review Articles