Aldarzi, K., Al-Rawi, W. (2020). Short Segment Posterior Instrumentation with Intermediate Screw in Thoracolumbar Junction Injury: Prospective Study. , 20(2), 116-127. doi: 10.52573/ipmj.2020.168619
Karam Fawaz Aldarzi; Walid W. Al-Rawi. "Short Segment Posterior Instrumentation with Intermediate Screw in Thoracolumbar Junction Injury: Prospective Study". , 20, 2, 2020, 116-127. doi: 10.52573/ipmj.2020.168619
Aldarzi, K., Al-Rawi, W. (2020). 'Short Segment Posterior Instrumentation with Intermediate Screw in Thoracolumbar Junction Injury: Prospective Study', , 20(2), pp. 116-127. doi: 10.52573/ipmj.2020.168619
Aldarzi, K., Al-Rawi, W. Short Segment Posterior Instrumentation with Intermediate Screw in Thoracolumbar Junction Injury: Prospective Study. , 2020; 20(2): 116-127. doi: 10.52573/ipmj.2020.168619

Short Segment Posterior Instrumentation with Intermediate Screw in Thoracolumbar Junction Injury: Prospective Study

Iraqi Postgraduate Medical Journal
Article 4, Volume 20, Issue 2, 2021, Pages 116-127    PDF (623.24 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2020.168619
Authors
Karam Fawaz Aldarzi* 1, 2; Walid W. Al-Rawi3
1Resident of neurosurgery in the Accident and Emergency Teaching Hospital, Duhok City
2Iraqi Board of Medical Specialization, Baghdad, Iraq
3College of Medicine, University of Duhok, Chief Consultant Neurosurgeon, The Accident and Emergency Teaching Hospital, Duhok, Iraq.
Abstract
BACKGROUND:
Thoracolumbar fractures are traditionally treated surgically by short segment fixation;
however, they may be associated with high implant failure. The insertion of an additional screw at
fracture site makes it more stable with a better clinical outcome.
OBJECTIVE:
The aim was to evaluate the radiological and clinical parameters of posterior short
segment fixation with intermediate screw implantation into the fractured vertebra.
METHODS:
We evaluated 30 patients with unstable thoracolumbar fractures, managed with short
segment posterior instrumentation with intermediate screw in the fractured vertebra; fractures
classification was done according to AOspine and TLICS systems . Eighteen male and 12 females
qualified for the study; male to female ratio was 1.5:1; average age 28.86 years. Neurological status
was classified according to the ASIA impairment scale. Pain was evaluated by VAS score. The
percentage of vertebral body collapse and segmental kyphosis were assessed by Cobb method.
Duration of follow-up lasted for 12 months.
RESULTS:
The mean preoperative VAS score was 8.55, had significantly improved to 0.87 at final
follow up. Preoperative mean vertebral body collapse was 48.40%, which had significantly improved
to 12.85% at final follow up. Mean segmental kyphotic angle was 21.83° before surgery, final mean
segmental kyphosis was 8.63°. Fifteen patients with incomplete neurologic deficits had improvement
by at least one ASIA grade on final follow-up observation, and 2 of 4 patients with complete
neurologic deficit remained unchanged. All neurologically intact patients remained unchanged. None
of patients had implant failure.
CONCLUSION:
Short segment fixation with intermediate screws in treatment of thoracolumbar junction
fracture effectively improve stability with most of patients achieve significant improvement in clinical
outcomes.
Keywords
Thoracolumbar injury; Short segment fixation; Intermediate screw; Transpedicular screw
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