Management of unstable thoraco lumbar fractures using short segment posterior fixation with index level screws versus long segment posterior fixation a prospective observational study

Abstract

Background: Thoracic and lumbar fractures account for approximately 90% of severe spinal injuries. The thoracolumbar region is prone to injuries due to its positioning between the rigid kyphotic thoracic spine and the flexible lordotic lumbar region. This study aimed to evaluate the results of short-segment fixation using index level pedicle screw with traditional long-segment fixation (LSF) for treating unstable fractures at the thoracolumbar junction. newlineMethods: A prospective comparative study was conducted from December 2020 to September 2022, involving a total of 30 patients who underwent Posterior Decompression and Stabilization surgery for unstable thoracolumbar fractures. The surgery involved the use of short-segment fixation with pedicle screws at the index level and long-segment fixation (LSF). Patients were monitored and assessed using the ASIA Motor score, VAS Score, ODI score, Segmental kyphotic angle, and Becks index for a duration ranging from 6 months to 1 year. newlineResults: The two groups exhibited similarities degree, pre-operative, as well as in their follow-up (p gt 0.05). Half of the patients (50%) received short (50%) received long- The comparison of during the preoperative period, at 3 months, and at 6 months did not reveal any However, during and at 1 month, highly statistical ODI scores between the groups during the preoperative period and at 6 months did not exhibit any statistical significance (p gt 0.05). However, during the postoperative phase, the ODI scores at 1 month and 3 months showed a high level of statistical significance average local kyphotic angle before surgery was 18.79° ± 4.34°, and the angle of correction during follow-up was 14.80° ± 2.83°. average local before surgery was 21.15° ± 5.35°, and the angle of correction was 13.66° ± 6.60. The ABH/PBH ratio at the post-operative period (.289; p = 0.955). newlineConclusion: Short-segment stabilization with an index level screw involves less manipulation of soft tissues, requires fewer implanted hardware components, and provides faster postoperative pain relief compared to long-segment stabilization with equivalent biomechanical stability. Additionally, these patients get prompt alleviation of pain and are able to resume their regular daily activities. Our study found group that underwent short segment fixation with an index level screw and the group that functional and result. Nevertheless, we observed a substantial disparity in the intraoperative and postoperative periods among newlineKeywords: Thoracolumbar fracture, with index level screw, ODI score, Local kyphotic angle, Becks index.