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Comparison of surgical outcomes in thoracolumbar fractures operated with posterior constructs having varying fixation length with selective anterior fusion

 Hak Sun Kim  ;  Seung Yup Lee  ;  Ankur Nanda  ;  Ju Young Kim  ;  Jin Oh Park  ;  Seong Hwan Moon  ;  Hwan Mo Lee  ;  Ho Joong Kim  ;  Huan Wei  ;  Eun Su Moon 
 YONSEI MEDICAL JOURNAL, Vol.50(4) : 546-554, 2009 
Journal Title
Issue Date
Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Radiography ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/surgery* ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/injuries ; Thoracic Vertebrae/surgery* ; Treatment Outcome ; Young Adult
Thoracolumbar burst fracture ; fixation length ; intermediate segment fixation ; posterior instrumentation ; selective anterior fusion
PURPOSE: Surgical treatment in the case of thoracolumbar burst fractures is very controversial. Posterior instrumentation is most frequently used, however, but the number of levels to be instrumented still remains a matter of debate. MATERIALS AND METHODS: A total of 94 patients who had a single burst fracture between T11 and L2 were selected and were managed using posterior instrumentation with anterior fusion when necessary. They were divided into three groups as follows; Group I (n = 28) included patients who were operated by intermediate segment fixation, Group II (n = 32) included patients operated by long segment fixation, and Group III (n = 34) included those operated by intermediate segment fixation with a pair of additional screws in the fractured vertebra. The mean follow-up period was twenty one months. The outcomes were analyzed in terms of kyphosis angle (KA), regional kyphosis angle (RA), sagittal index (SI), anterior height compression rate, Frankel classification, and Oswestry Disability Index questionnaire. RESULTS: In Groups II and III, the correction values of KA, RA, and SI were much better than in Group I. At the final follow up, the correction values of KA (6.3 and 12.1, respectively) and SI (6.2 and 12.0, respectively) were in Groups II and III found to be better in the latter. CONCLUSION: The intermediate segment fixation with an additional pair of screws at the fracture level vertebra gives results that are comparable or even better than long segment fixation and gives an advantage of preserving an extra mobile segment.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ju Young(김주영)
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Kim, Ho Joong(김호중)
Moon, Seong Hwan(문성환)
Moon, Eun Su(문은수)
Park, Jin Oh(박진오)
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
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