Comparison of the Clinical and Radiologic Outcomes of Two Treatment Methods in Patients with Thoracolumbar Junction Distraction Fracture: Short- versus Long-Segment Posterior Stabilization

Abstract

Background We compare the radiologic and clinical results between the short-segment fixation and the long-segment fixation in the thoracolumbar junction distraction fractures.

Methods We retrospectively reviewed the prospectively recorded data of patients who underwent posterior approach and pedicle fixation treatment for thoracolumbar distraction fracture (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association AO/OTA 5-B) with a minimum of 2 years of follow-up. A total of 31 patients were operated on; they were divided into two groups: (1) patients treated with short-level fixation (SLF; one level above and below the fracture level) and (2) patients treated with long-level fixation (LLF; two levels above and below the fracture level). The clinical outcomes were evaluated with the neurologic status, operation time, and time to surgery. The functional outcomes were evaluated with the Oswestry Disability Index (ODI) questionnaire and visual analog scale (VAS) at the final follow-up. Radiologic outcomes were measured with the local kyphosis angle, anterior body height, posterior body height, and sagittal index of the fractured vertebra.

Results SLF was performed in 15 patients and LLF was performed in 16 patients. The average follow-up period was 30.13 ± 11.3 months for the SLF group and 35.3 ± 17.2 months for group 2 (p = 0.329). The two groups were similar in regard to age, gender, follow-up period, fracture level, fracture type, and pre- and postoperative neurologic status. The operating time was significantly shorter in the SLF group than in the LLF group. There were no significant differences between the groups in all radiologic parameters, ODI score, and VAS.

Conclusion SLF was associated with a shorter operation time and allowed the preservation of two or more segments of vertebral motion.

Keywords

thoracolumbar junction distraction fracture - short-level fixation - long-level fixation - local kyphosis angle

Ethical Approval

This study was approved by the institutional review board of our university medical faculty hospital.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Publication History

Received: 12 September 2022

Accepted: 07 March 2023

Accepted Manuscript online:
13 March 2023

Article published online:
27 September 2023

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