Outcomes of Thoracolumbar Fracture-Dislocation Managed by Short-Segment and Long-Segment Posterior Fixation: A Single-Center Retrospective Study
Samarth Mittal, Syed Ifthekar, Kaustubh Ahuja, Bhaskar Sarkar, G. Singh, Arvind Rana, Pankaj Kandwal
Abstract
<h3>ABSTRACT</h3> <h3>Background:</h3> Long-segment posterior fixation has been used as a mainstay treatment of spine fracture-dislocations. Studies using short-segment posterior fixation in cases of thoracolumbar fracture-dislocation are limited. We describe our experience of 26 patients with thoracolumbar fracture-dislocation treated by short-segment or long-segment posterior spinal fixation and fusion. <h3>Methods:</h3> This is a single-center retrospective study of 26 patients with thoracolumbar fracture-dislocation treated by long-segment (group 1, n = 12) and short-segment posterior instrumentation (group 2, n = 14). Clinical (visual analog scale [VAS], Oswestry Disability Index [ODI]), neurological (American Spinal Injury Association [ASIA] scale), radiological (kyphotic angle, translational percentage, and displacement angle), and surgical (blood loss, operative time) outcomes and complications were recorded with each method. The mean follow-up period was 8.64 months (6–20 months). <h3>Results:</h3> The mean duration of surgery was 3.92 ± 0.67 hours in group 1 and 3.21 ± 0.54 hours in group 2, and mean blood loss was 583.33 ± 111.5 mL and 478.6 ±112.2 mL in groups 1 and 2, respectively (<i>P</i> < .05). There was no radiologically visible pseudarthrosis, implant failure, or screw breakage in either group at follow up with no statistically significant difference between the 2 groups with regard to the radiological outcome (<i>P</i> > .05). Two patients in group 1 and 6 patients in group 2 improved after surgery at least 1 ASIA grade. VAS and ODI improved in both groups at the final follow up. <h3>Conclusions:</h3> Short-segment fixation can be used for treating fracture-dislocation patients, as it results in less blood loss, decreased intraoperative time, and saves fusion segments with similar radiological and clinical outcomes as long-segment fixation. <h3>Level of Evidence:</h3> 3.