Long segment instrumentation of thoracolumbar burst fracture: fusion versus nonfusion.
OBJECTIVE
The treatment of thoracolumbar burst fracture is a controversial issue. Although spinal fusion has been a touchstone of spinal fixation, nonfusion technique have become raising its popularity recently. Some studies suggested that nonfusion had several advantages over fusion. The aim of this prospective study was to compare long segment posterior instrumentation with fusion versus long-segment posterior instrumentation without fusion.


METHODS
For this purpose, 42 consecutive patients were assigned to two groups. Group 1 included 21 patients treated by long segment instrumentation with fusion (WF), whereas Group 2 included 21 patients treated by long segment instrumentation without fusion (WOF). Long segment instrumentation was hook fixation (claw hooks attached to second upper vertebra and infralaminar hooks attached to first upper vertebra) above and pedicle fixation (pedicle screws attached to first and second lower vertebrae) below the fractured vertebra.


RESULTS
Measurements of local kyphosis, sagittal index and anterior vertebral height compression showed that both group had similar outcome at final follow-up. Moreover, there was no difference between the two groups according to low back outcome score. Also, implant failure rate (4.7%) was quite low in both groups. However, WF group had prolonged operative time, increased blood loss and donor site morbidity.


CONCLUSIONS
Radiological and clinical parameters demonstrated that spinal fusion is not necessary in long segment posterior instrumentation for the management of thoracolumbar burst fractures.
Tezeren
Gunduz
G
Cumhuriyet University School of Medicine, Department of Orthopaedics and Traumatology, Sivas, Turkey. gtezeren@yahoo.com/gtezeren@cumhuriyet.edu.tr
Bulut
Okay
O
Tukenmez
Mehmet
M
Ozturk
Hayati
H
Oztemur
Zekeriya
Z
Ozturk
Ali
A
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods* / Q000534:rehabilitation; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D020127:Recovery of Function; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D055815:Young Adult