Romanian Neurosurgery (Mar 2024)
Comparative study of thoracolumbar fractures posterior fixations between long segment and short segment involving the fractured vertebra
Abstract
Background. Thoracolumbar fractures are among the most common and unstable traumatic injuries to the spine. They require a rigid fixation. However, there are controversies in the choice of fixation types. This study aimed to compare long-segment posterior fixation (LSPF) bridging the injured vertebra and short-segment fixation with screws in the fractured vertebra (SSFFV). Methods. This was an analytical study of 22 patients admitted to the Kinshasa University Teaching Hospital from 2020 to 2023 with thoraco-lumbar fractures. Variables of interest included: sex, age, occupation, cause of fracture, ASIA score, injured vertebra, Magerl fracture types, Sagittal Cobb angle (SCA), and level of fixation. Data were analysed using SPSS 26 software. Results. Ten patients (45.4%) had SSFFV and 12 (54.6%) had LSPF. Overall, the sex ratio was 4.5 and, the mean age was 35.27±9.88 years. Road accidents accounted for 72.7% of causes, fracture of L1 (50%), ASIA A (41%) and Magerl B (54,5%). Pre-operative features did not show a difference between the two fixations. No difference was observed in function values before surgery (p=0.863) and at one year postoperatively (p=0.914). The mean SCA was 15.57 ± 5.90° before surgery, and 12.60±5.94° one year after surgery showing a significant correction of local kyphosis of 3° (P <0.001). There was no significant difference in the degrees of correction of local kyphosis immediately postoperatively (p=0.591) and at one year postoperative (p=0.819) and also in the degrees of loss of local kyphosis (p=0.870) between SSFFV and LSPF. Conclusion. This study did not show a significant difference in functional recovery, reduction and loss of correction of traumatic kyphosis between the two fixations. The SSFFV therefore appears to be an effective alternative to LSPF.
