title: Short segment posterior instrumentation, reduction and fusion of unstable thoracolumbar burst fractures--a review of 26 cases.
abstract: From January 1994 to January 1998, 26 patients of unstable thoracolumbar burst fracture were treated by a short segment posterior instrumentation (pedicular screw plate/rod system), reduction and fusion in Kuala Lumpur and Universiti Kebangsaan Malaysia Hospital. Majority of them were young and in a productive age group (mean age were 30 year-old). The mean duration of follow-up was 24.4 months. The injuries were caused by fall from height (69%) and motor vehicle accident (31%). Most of the fracture occurred at 1st and 2nd lumbar vertebrae (24/26). Twelve of the patients did not have neurological deficits. Out of 14 patients with neurological deficits, 64.4% of them showed an improvement of at least one Frankel's grade. There was no defect correlation between canal compromise and neurological deficit. Kyphotic angle improved from 20 degrees to 7 degrees immediately after surgery. In the last follow-up average kyphotic angle was 9 degrees with average lost of 2 degrees. The average length of hospitalization following surgery was 24 days. A posterolateral bony fusion was achieved in all cases at an average of 3 months. Complication included 2 loosening and 3 misplacement of pedicle screw fixation. We concluded that short-segment fixation with posterolateral decompression and fusion is effective in the treatment of unstable thoracolumbar burst fracture.
authors.affiliation: Department of Orthopaedic & Traumatology, Hospital Universiti Kebangsaan Malaysia, Jalan Tenteram, Cheras, 56000 Kuala Lumpur.
authors.forename: M
authors.initials: M
authors.lastname: Razak
authors.forename: M M
authors.initials: MM
authors.lastname: Mahmud
authors.forename: M Y
authors.initials: MY
authors.lastname: Hyzan
authors.forename: A
authors.initials: A
authors.lastname: Omar
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000293:injuries*