title: Pedicle screw instrumentation for unstable thoracolumbar fractures.
abstract: We evaluated the results of short-segment pedicle screw instrumentation in 54 patients with unstable thoracolumbar fractures. Follow-up averaged 25 months (range, 11 to 36 months); 42 patients completed the study. Kyphosis was corrected by an average of 7 degrees at surgery and loss of correction averaged 5 degrees at the end of follow-up. On computed tomography, canal compromise averaged 57% preoperatively and 33% postoperatively. Complications included nerve root irritation due to screw penetration (1/42), screw breakage (2/42), and screw bending (6/42). Solid fusion was achieved in all cases at an average of 3 months. Of the 31 patients with normal neurologic function, 24 (77%) were pain-free at follow-up and had returned to previous levels of activity. We conclude that short-segment fixation with posterolateral fusion is effective in the treatment of unstable thoracolumbar fractures; it prevents progression of kyphotic deformity and neurologic deterioration, results in a stable fusion, and preserves uninvolved motion segments above and below the fracture site.
authors.affiliation: Division of Orthopaedic Surgery, Medical College of Georgia, Augusta, USA.
authors.forename: D O
authors.initials: DO
authors.lastname: Stovall
authors.forename: A
authors.initials: A
authors.lastname: Goodrich
authors.forename: A
authors.initials: A
authors.lastname: MacDonald
authors.forename: P
authors.initials: P
authors.lastname: Blom
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D007593:Joint Instability / Q000601:surgery*; D007738:Kyphosis / Q000517:prevention & control / Q000601:surgery; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery