Making short-segment posterior fixation more successful in treatment of unstable thoracolumbar fracture

Background
Short-segment posterior fixation (SSPF) is liable to failure in unstable thoracolumbar fracture because of disruption of load-bearing anterior column. Intermediate screw and intracorporeal transpedicular grafting increase the stability of construct and enhance fracture healing, thereby avoiding long-segment posterior fixation and demanding anterior surgery in unstable thoracolumbar fracture.


Patients and methods
There were 20 patients with unstable thoracolumbar fractures treated with SSPF and TIG. These patients were followed for at least 14 months for to assess clinical improvement and the ability of the technique to reduce the fractures and maintain kyphosis correction with absence of implant failure.


Result
All patients were operated within the first week, with a mean time delay of 3.4 days. There were no cases with deep postoperative infection, iatrogenic dural tear, deterioration of neurologic deficit, or implant failure. The mean local kyphosis angle was 22.9° preoperatively, 9.7° postoperatively, and 11° at final examination. The mean anterior height collapse was 55.9% preoperatively, 87.5% postoperatively, and 79.8% at final examination.


Conclusion
SSPF with intermediate screw and TIG is an effective and safe technique in the treatment of unstable thoracolumbar fracture, with good clinical and radiological results.