RETROSPECTIVE COMPARATIVE ANALYSIS OF SURGICAL TREATMENT OF THORACOLUMBAR BURST FRACTURE: SHORT VERSUS LONG FIXATION

ABSTRACT Objective: The objective of this study is to compare short posterior fixation to long posterior fixation in thoracolumbar burst fractures. Methods: Fifty-three patients were divided into Group I (n=24) treated with short instrumentation (one level above and one below the fracture) and into Group II (n=29) treated with long instrumentation (two or more levels above and below the fracture). The load sharing classification was used to stratify cases. The evaluation of the sagittal index was performed using the Cobb method. Results: In subgroups with load sharing classification ≤ 6, Group I had loss of correction of 4.2 degrees and a procedure failure in 14.3% of cases, Group II showed loss of correction of 5.4 degrees and failure in 21.7% of cases. In subgroups with load sharing classification ≥7, Group I had a loss of correction of 11.2 degrees and procedure failure in 70% of cases, and Group II showed a loss of correction of 9 degrees and failure of 46.7%. Group I had a tendency to worse outcomes, especially in the subgroup of patients with load sharing classification ≥7. Conclusion: Despite the tendency for poorer results in the short fixation group in the cases with load sharing ≥7, in no sample was there statistically significant difference between the groups studied.

摘要 研究目的：本研究旨在对比胸腰椎爆裂骨折患者采用短节段后路固定与长节段后路固定的临床效果。方法：将53例患者分为两组，I组（n=24）采用短节段内固定（骨折节段上下各1个节段），II组（n=29）采用长节段内固定（骨折节段上下各2个及以上节段）。研究采用载荷分担分类（load sharing classification）对病例进行分层，并通过Cobb法评估矢状位指数。结果：在载荷分担分类≤6的亚组中，I组矫正丢失角度为4.2°，手术失败率为14.3%；II组矫正丢失角度为5.4°，手术失败率为21.7%。在载荷分担分类≥7的亚组中，I组矫正丢失角度为11.2°，手术失败率为70%；II组矫正丢失角度为9.0°，手术失败率为46.7%。I组预后表现更差，尤其在载荷分担分类≥7的患者亚组中。结论：尽管短节段固定组在载荷分担分类≥7的病例中呈现出较差的预后趋势，但两组研究对象间未出现统计学显著性差异。