Abstract
The study is been conducted to compare the outcome of pedicle screw fixation in dorsolumbar fractures by long segment fixation and short segment fixation with a screw in fractured vertebra.
Study includes the consecutive patients of dorsolumbar fractures treated by either long segment or short segment fixation. Twenty patients were included in each category. Patients with or without neurological deficit were included. Patients with single fractured vertebra only were included.
Patients with single level dorsolumbar fracture were subjected to detailed radiological analysis preoperatively by measurement of height loss and kyphosis angle of fractured vertebra. Detailed neurological status was recorded. During the fixation the pedicle screw was inserted in less affected pedicle of fractured vertebra and decompression if needed was done by hemilaminectomy of other side. Bone graft
Postoperative kyphosis correction and restoration of height was calculated in both the groups. At 3 months, 12months and 24 months the maintenance of corrected kyphosis and restored height was recorded.
Neurological examination to record the effect of surgical intervention on neurological recovery was recorded at every examination.
All the patients had satisfactory outcome. The loss of correction in both the groups was comparable.
The treatment allows easier postoperative nursing and early mobilization of the patient. Segmental fixation with screws at the level of the fracture offers improved biomechanical stability. It allows additional fixation points that may aid in fracture reduction and kyphosis correction. It also reduces the duration of surgery, blood loss as well as cost of implant without significant compromise on outcome.
Pedicle screw at the level of fracture in short segment fixations provides added stability, better postoperative maintenance of corrected kyphosis at reduced cost of implant.
