• World Neurosurg · Nov 2018

    Modified Posterior Short-Segment Pedicle Screw Instrumentation for Lumbar Burst Fractures with Incomplete Neurological Deficit.

    • Sheng Yang, De-Peng Shang, Jian-Min Lu, Ji-Feng Liu, Da-Peng Fu, Fei Zhou, Yang Cong, and Zhong-Zhe Lv.
    • Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian People's Republic of China. Electronic address: yangsheng_88@163.com.
    • World Neurosurg. 2018 Nov 1; 119: e977-e985.

    PurposeWe have introduced a method of modified posterior short-segment pedicle screw fixation and evaluated its clinical effects in treating lumbar burst fractures with incomplete neurological deficits.MethodsThe data from 22 patients with lumbar burst fracture and incomplete neurological deficits who had undergone modified posterior short-segment instrumentation with Schanz screw fixation from January 2012 to February 2018 in our clinic were evaluated in the present retrospective study. All Schanz screws were implanted in an oblique downward direction into the vertebrae above and below the injured vertebra (insertion depth, 90%-100%). The implants were removed ∼1 year after surgery. Neurological function, back pain, anterior and posterior body height ratio, kyphosis angle, percentage of canal compromise, fracture severity, and treatment-related complications were evaluated.ResultsTechnical success was achieved in all 22 patients. No infection, instrument loosening or failure, or breakage was observed. Statistically significant improvements with regard to the anterior body height (P < 0.05) and posterior body height (P < 0.05) ratios, kyphosis angle, and percentage of canal compromise (P < 0.05) were observed at 1 week postoperatively or the final follow-up visit. No correction loss had occurred at the final follow-up examination. Postoperatively, all patients with neurological deficits had functional improvement equivalent to ≥1 grade on the American Spinal Injury Association impairment scale and fracture union. Back pain was greatly improved postoperatively.ConclusionsShort-segment Schanz screw fixation implanted in an oblique downward direction seems to be a promising method for lumbar burst fractures with incomplete neurological deficits because it provided good clinical and radiographic outcomes.Copyright © 2018 Elsevier Inc. All rights reserved.

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