Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Short Segment Fixation for Thoracolumbar Burst Fracture Accompanying Osteopenia : A Comparative Study

  • Kim, Hyeun Sung (Department of Neurosurgery, Heori Sarang Hospital) ;
  • Kim, Seok Won (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Ju, Chang Il (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Lee, Sung Myung (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Shin, Ho (Department of Neurosurgery, College of Medicine, Chosun University)
  • Received : 2012.07.31
  • Accepted : 2013.01.15
  • Published : 2013.01.28
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Abstract

Objective : The purpose of this study was to compare the results of three types of short segment screw fixation for thoracolumbar burst fracture accompanying osteopenia. Methods : The records of 70 patients who underwent short segment screw fixation for a thoracolumbar burst fracture accompanying osteopenia (-2.5< mean T score by bone mineral densitometry <-1.0) from January 2005 to January 2008 were reviewed. Patients were divided into three groups based on whether or not bone fusion and bone cement augmentation procedure 1) Group I (n=26) : short segment fixation with posterolateral bone fusion; 2) Group II (n=23) : bone cement augmented short segment fixation with posterolateral bone fusion; 3) Group III (n=21) : bone cement augmented, short segment percutaneous screw fixation without bone fusion. Clinical outcomes were assessed using a visual analogue scale and modified MacNab's criteria. Radiological findings, including kyphotic angle and vertebral height, and procedure-related complications, such as screw loosening or pull-out, were analyzed. Results : No significant difference in radiographic or clinical outcomes was noted between patients managed using the three different techniques at last follow up. However, Group I showed more correction loss of kyphotic deformities and vertebral height loss at final follow-up, and Group I had higher screw loosening and implant failure rates than Group II or III. Conclusion : Bone cement augmented procedure can be an efficient and safe surgical techniques in terms of achieving better outcomes with minimal complications for thoracolumbar burst fracture accompanying osteopenia.

Keywords

References

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