title: Thoracolumbar burst fractures requiring instrumented fusion: Should reducted bone fragments be removed? A retrospective study.
abstract: BACKGROUND
  Thoracolumbar burst fractures are common clinical entity encountered in neurosurgical practice, accounting for 10-20% of all spinal fractures. Clinical picture could be devastating due to severe neurological deficits which lead the patients dependent both socially and emotionally.
  
  
  METHODS
  This study compared two groups of patients who were operated because of thoracolumbar burst fracture secondary to spinal trauma in terms of neurologic deficits, degree of improvement, and radiologic measurements at one-year follow-up. The first group (group I) included the patients who underwent posterior total laminectomy, peroperative reduction of intracanal bone fragments, and posterior spinal instrumentation and the second group (group II) included the patients who underwent total laminectomy, and spinal instrumentation without reduction of free bone fragments.
  
  
  RESULTS
  Neither group showed significant correlation with any measurement parameter. Radiological assessments and clinical improvements did not disclosed significant difference between the two groups at one-year follow-up.
  
  
  CONCLUSIONS
  Retropulsion of free bone fragments extend the time of surgery and causes complications. This study found that there is no need to retropulse the bone fragments in the spinal canal in patients with unstable burst fractures who underwent total laminectomy and posterior long segment stabilization.
authors.affiliation: Sakarya University Training and Research Hospital, Department of Neurosurgery, Sakarya, Turkey. Electronic address: drcanyaldiz@yahoo.com.
authors.forename: Can
authors.initials: C
authors.lastname: Yaldiz
authors.affiliation: Sakarya University Training and Research Hospital, Department of Radiology, Sakarya, Turkey.
authors.forename: Kıyasettin
authors.initials: K
authors.lastname: Asil
authors.affiliation: Alanya Government Hospital, Clinic of Neurosurgery, Alanya, Turkey.
authors.forename: Birol
authors.initials: B
authors.lastname: Özkal
authors.affiliation: Sakarya University Training and Research Hospital, Department of Neurosurgery, Sakarya, Turkey.
authors.forename: Davut
authors.initials: D
authors.lastname: Ceylan
authors.affiliation: Sakarya University Training and Research Hospital, Department of Neurosurgery, Sakarya, Turkey.
authors.forename: Tibet
authors.initials: T
authors.lastname: Kacira
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods*; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome
keywords: Bone fragment; Posterior spinal instrumentation; Thoracolumbar burst fracture