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REVIEW ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 2  |  Page : 72-75

Outcome of short same-segment fixation in thoracolumbar junction fractures


1 Resident (3rd Year), Department of Orthopedics, B. J. Medical College, Ahmedabad, Gujarat, India
2 Associate Professor, Department of Orthopedics, B. J. Medical College, Ahmedabad, Gujarat, India
3 Resident (2nd Year), Department of Orthopedics, B. J. Medical College, Ahmedabad, Gujarat, India

Correspondence Address:
Shubham Jain
Resident (3rd Year), Department of Orthopedics, B. J. Medical College, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10039-1131

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Background: Short same-segment posterior fixation (SSPF) minimizes the number of vertebral levels involved in fixation of a spine fracture. Short same-segment posterior fixation with pedicle fixation at the level of the fracture suggests biomechanical advantages toward maintenance of kyphosis correction, reducing failure rates with the aim of improving spinal motion and early rehabilitation.[1],[2],[3],[4] Materials and methods: All patients with thoracolumbar junction fractures included in our study were evaluated between 2014 and 2016 with biomechanical criteria and clinical outcome. The immediate postoperative radiographs were compared with radiographs of each follow-up, evaluating any loss of correction by measuring kyphotic angle using Cobb's method, also at each follow-up, clinical outcome was measured using Oswestry disability index. The intraobserver and interobserver reliability were analyzed. Results: There were 35 patients with unstable thoracolumbar fractures in our study who were operated using posterior spinal fixation system during 2014 to 2016 with pedicle screw insertion at the level of the fractured vertebrae. The average follow-up was 18 months. The average preoperative kyphotic angle as measured by Cobb's method in all the cases was 17.2°, which improved to 5.9°, achieving a mean of 65% correction immediately postoperatively. At final follow-up, average postoperative Cobb's angle was 7.7°, maintaining 55% correction at final follow-up. Disability improved from 78% mean preoperatively to 47.27% mean postoperatively at final follow-up. Conclusion: Short same-segment posterior fixation decreases implantation failure rate and has better biomechanical stability compared with traditional SSPF; however, long-term kyphosis correction to a greater extent was not maintained, which was also statistically insignificant. Despite this loss of kyphosis correction, clinical pain and disability improved at long-term follow-up.


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