RESUMEN
STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the canal encroachment of fractured bony fragments and neurological deficits of pedicle screw instrumentation for the treatment of unstable thoracolumbar burst fractures with pedicle screws inserted into the fractured vertebrae. MATERIALS AND METHODS: The authors evaluated 18 patients treated surgically with posterior fusions using pedicle screws for unstable thoracolumbar burst fractures, from March 2000 to September 2004. The ratios of the areas occupied by the fractured bony fragments in the canals were analyzed, before and after pedicle screw insertion, by computed tomography scans of the fractured vertebrae. The kyphotic angles, anterior vertebral heights, and neurological deficits were evaluated. RESULTS: The areas occupied by the fractured fragments in the canals were improved significantly after surgery and there were no neurological complications resulting from the placement of pedicle screws or fragment displacements. The kyphotic angles and anterior vertebral heights at the last follow-up visits were improved significantly compared with the preoperative radiographs. The neurological deficits were not aggravated after pedicle screw insertion. CONCLUSION: Our results suggest that pedicle screw instrumentation in fractured vertebrae is safe and effective for the treatment of unstable thoracolumbar burst fractures.