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Article Type

Original Study

Abstract

Background The optimal management of thoracolumbar spine fractures remains a matter of controversy. The literature implies that the use of short-segment (SS) pedicle screw fixation may be inappropriate because of its high reported failure rate. To overcome this, currently long-segment (LS) pedicle instrumentation for thoracolumbar (T-L) fractures is gaining popularity. Aim The aim was to assess and compare the efficacy and safety of LS versus SS fixation with posterior decompression for the treatment of traumatic thoracolumbar burst fractures. Patients and methods This prospective study was carried out at the Department of Neurosurgery, Matarya Teaching Hospital. A total of 70 patients in whom the unstable burst thoracolumbar fractures were confirmed were included, where 35 patients (15 male and 20 female) had LS fixation and decompression, whereas 35 (16 male and 19 female) patients had SS fixation and decompression. LS fixation includes two levels above and two levels below, whereas short fixation involves vertebra above and vertebra below the fractured one. Ethics committee approval was taken. Results Clinical outcome was assessed according to Modified-Macnab Criteria. Overall, 34.3 and 57.1% showed excellent and good results, respectively, among LS group and 11.4 and 51.4% showed excellent and good results, respectively, among SS group. Cobb's angle evaluation was used to assess radiological outcome. Conclusion LS fixation with posterior decompression is significantly effective in treating patients of unstable traumatic burst thoracolumbar fractures than SS fixation and decompression.

Keywords

Burst fractures, decompression, long-segment fixation, short-segment fixation, thoracolumbar spine, Transpedicular instrumentation

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