Pedicle screw fixation at the level of the fracture: The postoperative kyphosis rate and replacement of the fractured body

Abstract

The tendency to use internal fixation with surgery to remove penetrating fragments in the spinal canal even in the absence of neurological deficits has increased. All 3 methods of posterior, anterior, and combination fixations are used, and yet the optimal management of thoracolumbar fractures is controversial. There is a lack of comprehensive review comparing the 2 methods of embedded systems in fractured vertebrae (segmented) and nonembedded pedicular screws in fractured vertebrae (nonsegmented). Twenty adult patients with vertebral fracture were evaluated in this randomized clinical trial. Patients underwent radiologic evaluations, before and after surgery at 1.5-, 3-, and 6-month control periods to assess the reversal of kyphosis and fracture displacement between the 2 groups. Nonsegmented and segmented methods, respectively, were performed on group A (10 cases) and group B (10 cases) patients. The average kyphosis before operation was 10±6.9 degrees in group A, whereas 18.2±7.1 degrees in group B. The average rates of kyphosis correction in patients at the 1.5- and the 6-month intervals, respectively, were 8.3±2.7 degrees and 4.8±2.5 degrees in group A and 14.1±3.7 degrees and 8.4±5 degrees in group B, respectively. The correlation between preoperative deformity and the amount of kyphosis correction in group A was not significant (P=0.12), whereas this correlation was statistically significant in group B (P=0.04). © 2013 Wolters Kluwer Health, Inc. All rights reserved.