Bi-Pedicle Fixation of Affected Vertebra in Thoracolumbar Burst FractureCorrespondence Address :
Dr. Varshil Mehta,
103, Sky High Tower, Orlem, Tank Road, Malad West, Mumbai-400064, Maharashta, India.
Introduction: Burst fractures of the spine account for 14% of all spinal injuries and more than 50% of all thoracolumbar trauma. However, there is ambiguity while choosing the right treatment plan. Short Segment Pedicle screw Fixation (SSPF) has become an increasingly popular method of treatment of thoracolumbar burst fractures, providing the advantage of incorporating fewer motion segments in the fixation. Various biomechanical studies showed that the use of pedicle screws could achieve stable construct within short-segment fixation.
Aim: To evaluate the efficacy of SSPF using longest possible screws in both pedicles of fractured vertebra.
Materials and Methods: A retrospective chart review of 25 single burst thoracolumbar fracture patients, operated between May 2009 to 2015 in a tertiary care trauma center, was conducted. Preoperative and post-operative plain radiographs were evaluated for kyphotic angulations using the traditional Cobb method. Anterior Vertebral Height (AVH), Posteriors Vertebral Height (PVH) were measured preoperatively and immediate postoperatively. Average percentage loss of AVH and mid-sagittal height were calculated on preoperative and postoperative X-rays on follow up.
Results: Fourteen men and 11 women with an average age of 42.92 years comprised the study population. Mean age at the time of operation was 34.5±14.2 years. Mean operation time was 168±72 (minutes). Average hospitalization time was 9±7 (days). Mean blood loss was 515±485 (ml). There were two cases of postoperative infection and implant failure each. A mean of 15.2° of kyphosis correction was attained from preoperation to post-operation (p<0.0001). Although, there was a 15° average improvement of kyphosis post-fixation, loss of correction over time was nearly 8°, resulting in a 7° mean correction of kyphosis. A mean loss of AVH on postoperative radiograph was 6.12% and maintained 12.4% at the time of review (p<0.001). Similarly, there was 32.8% mid-sagittal height loss at time of injury, which was improved to only 12.6% as compare to initial height loss (p<0.0001).
Conclusion: In this study, we propose SSPF using longest possible screws in both pedicle of fractured vertebra. Bi-pedicular fixation gives significant radiological corrections.
Kyphosis, Short segment pedicle-screw fixation, Thoracolumbar fracture
Pravin Padalkar, Varshil Mehta. BI-PEDICLE FIXATION OF AFFECTED VERTEBRA IN THORACOLUMBAR BURST FRACTURE. Journal of Clinical and Diagnostic Research [serial online] 2017 April [cited: 2017 May 30 ]; 11:RC04-RC07. Available from
Date of Submission: Dec 23, 2016
Date of Peer Review: Jan 18, 2017
Date of Acceptance: Feb 01, 2017
Date of Publishing: Apr 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
- PubMed Central® (PMC)New
- Academic Search Complete Database
- Chemical Abstracts Service
- Directory of Open Access Journals (DOAJ)
- Embase & EMbiology
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Open J-Gate
- Popline (reproductive health literature)