title: Short-segment fixation without fusion for thoracolumbar burst fractures with neurological deficit can preserve thoracolumbar motion without resulting in post-traumatic disc degeneration: a 10-year follow-up study.
abstract: METHODS
  Prospective consecutive series.
  
  
  OBJECTIVE
  To evaluate the post-traumatic disc degeneration and range of motion 10 years after short-segment fixation without fusion for thoracolumbar burst fractures with neurological deficit.
  
  
  BACKGROUND
  Early clinical results of short-segment fixation without fusion for thoracolumbar burst fractures were satisfactory. However, the long-term results have not been reported, and post-traumatic disc degeneration and preservation of thoracolumbar motion have not been elucidated.
  
  
  METHODS
  Twelve patients who had thoracolumbar burst fractures and associated incomplete neurological deficit, operatively treated within 4 days of admission and had their implants removed within 1 year, were prospectively followed for at least 10 years. Following indirect reduction and pedicle screw fixation, transpedicular intracorporeal hydroxyapatite grafting to the fractured vertebrae was performed.
  
  
  RESULTS
  Sagittal alignment was improved from a mean preoperative kyphosis of 17° to -2° (lordosis) by operation, but was found to have slightly deteriorated to 2° at the final follow-up observation. With respect to back pain, 8 patients did not report back pain. Three reported occasional minimal pain, and 1 reported moderate pain. None reported severe pain or needed daily dosages of analgesics.Regarding disc degeneration, the shape of the disc adjacent to the fractured vertebra had not changed from the preoperative to the 10-year postoperative magnetic resonance image (MRI). Although signal intensity of the disc had decreased by 1 grade from the preoperative to the 2-year postoperative MRI, the intensity had not changed from the 2-year postoperative MRI to the 10-year postoperative MRI. At the 10-year follow-up, flexion-extension radiographs revealed that a mean range of motion at the disc adjacent to the fractured vertebra was 12º (range; 5-19).
  
  
  CONCLUSIONS
  This unprecedented 10-year follow-up study demonstrated that posterior indirect reduction, transpedicular hydroxyapatite grafting, and pedicle screw fixation does not require fusion to a segment, thereby preserves thoracolumbar motion without resulting in post-traumatic disc degeneration.
  
  
  METHODS
  4.
authors.affiliation: Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Ichihara-city, Chiba, Japan. tomotomot2001@gmail.com
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ozawa
authors.forename: Kunimasa
authors.initials: K
authors.lastname: Inada
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Shirahata
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Shiboi
authors.forename: Atsuya
authors.initials: A
authors.lastname: Watanabe
authors.forename: Keisuke
authors.initials: K
authors.lastname: Matsuki
authors.forename: Fumio
authors.initials: F
authors.lastname: Hasue
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fujiyoshi
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Aoki
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Wada
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tanaka
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D017886:Durapatite / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000209:etiology / Q000503:physiopathology; D007738:Kyphosis / Q000601:surgery; D008159:Lumbar Vertebrae / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017886:Durapatite