title: Restoration of Anterior Vertebral Height by Short-Segment Pedicle Screw Fixation with Screwing of Fractured Vertebra for the Treatment of Unstable Thoracolumbar Fractures.
abstract: BACKGROUND
  The treatment of unstable thoracolumbar fractures remains controversial. Long-segment pedicle screw constructs may be stiffer and impart greater forces on adjacent segments compared with short-segment constructs. Short-segment pedicle screw fixation alone may be associated with instrumentation failure. Reinforcement fractured vertebra by the placement of an additional 2 screws at fracture level may be useful in thoracolumbar fractures for restoration of anterior vertebral height.
  
  
  METHODS
  We retrospectively analyzed 35 patients (21 males, 14 females) with unstable thoracolumbar fractures. The patients were divided into 2 groups. In group I, patients were operated with posterior approach via the use of pedicle screws fixed long (2 levels above and 1 or 2 levels below of the fractured vertebra). In group II patients, short-segment stabilization with additional screwing at fracture level was made. Immediate postoperative radiologic evaluations were done by measuring the correction and maintenance of kyphotic angle at the fracture level, Cobb angle, and height of fractured vertebra.
  
  
  RESULTS
  Average local kyphosis angle, anterior kyphotic angle at the fracture level, and Cobb angle were not statistically significantly different in the postoperative period (P > 0.05); however, postoperative anterior height of fractured vertebra was statistically significantly different between the 2 groups (P < 0.05).
  
  
  CONCLUSIONS
  We compared a standard long-segment construct with a short-segment construct using instrumentation of the fractured segment. Short-segment pedicle screw fixation with screwing of fractured vertebra in unstable thoracolumbar fracture levels is an effective method to restoring anterior vertebral height for the treatment of unstable thoracolumbar fractures. It also provides anterior column support.
authors.affiliation: Department of Neurosurgery, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Ozdemir
authors.affiliation: Department of Neurosurgery, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey. Electronic address: ayhankanat@yahoo.com.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Kanat
authors.affiliation: Department of Neurosurgery, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Cihangir
authors.initials: C
authors.lastname: Erturk
authors.affiliation: Department of Neurosurgery, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Osman Ersagun
authors.initials: OE
authors.lastname: Batcik
authors.affiliation: Department of Orthopedic Surgery, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Mehmet Sabri
authors.initials: MS
authors.lastname: Balik
authors.affiliation: Department of Neurosurgery, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Yazar
authors.affiliation: Department of Radiology, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Fatma Beyazal
authors.initials: FB
authors.lastname: Celiker
authors.affiliation: Department of Radiology, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Metin
authors.affiliation: Department of Radiology, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Inecikli
authors.affiliation: Department of Neurosurgery, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Ali Rıza
authors.initials: AR
authors.lastname: Guvercin
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D009929:Organ Size; D065289:Pedicle Screws; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Anterior vertebral height; Fractured vertebra; Short-segment pedicle screw fixation; Thoracolumbar fractures