Short- and Long-segment Pedicle Screw Fixation with Anterior Interbody Fusion with Short Bone Graft in Denis type B Burst Fractures / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: The operative treatment methods of twenty-one patients with Denis type B burst fractures were evaluated according to the level of pedicle screw fixation. OBJECTIVE: To compare the results of short segment pedicle screw fixation with long segment pedicle screw fixation in Denis type B burst fractures treated anteriorly with short bone graft. SUMMARY OF BACK GROUND DATA Relatively good results(Short fusion time, good union rate, less loss of lordosis postoperatively etc.) were obtained in long segment fixation group during follow-up period. METHODS: Twenty-one patients with Denis B type burst fractures of thoracolumbar and lumbar spine were divided into two groups depend on the level of pedicle screw fixation in operative treatment methods, one group consisted of 10 cases which were treated by posterior short segment pedicle screw fixation and anterior interbody fusion with short bone graft(Group I one level above and below posteior pedicle screw fixation of the fracture site and upper end plate of fracture site was fused with autogenous iliac bone or rib to adjacent vertebral body anteriorly through involved disc space) and the other groups consisted of 11 cases which were treated by posterior long segment pedicle screw fixation and anterior interbody fusion with short bone graft (Group II more than two level above and below posterior pedicle screw fixation of the fracture site and additionally, anterior interbody fusion with short bone graft performed same as Group I). Bony union rate, union period, changes of height of bone and disc, kyphotic angle loss, interscrew angle and complications were measured using pre-, post-operative and follow-up radiographs and chart review. RESULTS: Comparing the two groups, there were no significant postoperative and follow-up results in both groups, especially, change of body & disc height, change of kyphotic angle and change of interscrew angle. However, relatively short fusion time, good union rate, less kyphotic angle loss, and low complication rates were obtainecl and maintained during follow-up period in long segment fixation lion group(Group II). CONCLUSIONS: Long segment pedicle screw fixation and anterior interbody fusion with short bone graft group could effectiyely treat Denis B type burst fractures of thoracolumbar & lumbar spine and maintain their postoperative results during follow up peroid.