• Bulent Ozdemir, Ayhan Kanat, Cihangir Erturk, Osman Ersagun Batcik, Mehmet Sabri Balik, Ugur Yazar, Fatma Beyazal Celiker, Yavuz Metin, Mehmet Fatih Inecikli, and Ali Rıza Guvercin.
• Department of Neurosurgery, Medical Faculty, Recep Tayyip Erdogan University, Rize, Turkey.
• World Neurosurg. 2017 Mar 1; 99: 409-417.

BackgroundThe 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.Material And MethodsWe 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.ResultsAverage 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).ConclusionsWe 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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