title: More than 5-Year Follow-up Results of Two-Level and Three-Level Posterior Fixations of Thoracolumbar Burst Fractures with Load-Sharing Scores of Seven and Eight Points.
abstract: BACKGROUND
  The development of pedicle screw-based posterior spinal instrumentation is recognized as one of the major surgical treatment methods for thoracolumbar burst fractures. However, the appropriate level in posterior segment instrumentation is still a point of debate. To assesses the long-term results of two-level and three-level posterior fixations of thoracolumbar burst fractures that have load-sharing scores of 7 and 8 points.
  
  
  METHODS
  From January 1998 to May 2009, we retrospectively analyzed clinical and radiologic outcomes of 45 patients with thoracolumbar burst fractures of 7 and 8 points in load-sharing classification who were operated on using two-level posterior fixation (one segment above and one segment below: 28 patients, group I) or three-level posterior fixation (two segments above and one segment below: 17 patients, group II). Clinical results included the grade of the fracture using the Frankel classification, and the visual analog score was used to evaluate pain before surgery, immediately after surgery, and during follow-up period. We also evaluated pain and work status at the final follow-up using the Denis pain scale.
  
  
  RESULTS
  In all cases, non-union or loosening of implants was not observed. There were two screw breakages in two-level posterior fixation group, but bony union was obtained at the final follow-up. There were no significant differences in loss of anterior vertebral body height, correction loss, or change in adjacent discs. Also, in clinical evaluation, there was no significant difference in the neurological deficit of any patient during the follow-up period.
  
  
  CONCLUSIONS
  In our study, two-level posterior fixation could be used successfully in selected cases of thoracolumbar burst fractures of 7 and 8 points in the load-sharing classification.
authors.affiliation: Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
authors.forename: Sub-Ri
authors.initials: SR
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
authors.forename: Hwa-Yeop
authors.initials: HY
authors.lastname: Na
authors.affiliation: Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
authors.forename: Jung-Mook
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
authors.forename: Dong-Chan
authors.initials: DC
authors.lastname: Eun
authors.affiliation: Department of Orthopedic Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Son
mesh_terms: D000328:Adult; D001416:Back Pain; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D065289:Pedicle Screws; D011183:Postoperative Complications; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000503:physiopathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Spinal fractures; Thoracolumbar fracture; Three level posterior screw fixation; Two level posterior screw fixation