A comparative analysis of the management of thoracolumbar burst fractures: short-segment posterior stabilization versus long-segment posterior instrumentation.

Introduction

The lumbar and thoracic spine sustain 90% of all spinal fractures. There is ongoing discussion regarding the most effective treatment for thoracolumbar burst fractures. Clinical results of long-segment and short-segment posterior stabilization are contrasted in this research. Materials and methods: There were thirty patients in total; fifteen underwent short-segment stabilization, and fifteen underwent long-segment stabilization. All patients were assessed and treated according to the advanced trauma life support (ATLS) protocol. Mobilization was started as tolerated. Postoperative X-rays were taken, and follow-up occurred monthly for six months, then every two months thereafter up to one year. Functional outcomes were determined by employing the ASIA impairment scale and VAS scores.

Results

Long-segment group operating times were 136.1±11.31 and 79.4±11.7 minutes, respectively, substantially longer than those of short-segment groups (p<0.05). In comparison to short-segment groups, long-segment groups experienced a statistically significant greater blood loss of 1263.3±151.74 and 876.7±189.8 ml, respectively (p<0.05). The ASIA impairment scale measurement, change in Beck’s index, and kyphotic angle were statistically insignificant among both groups. In the long-segment group, most patients had a Denis pain scale score of P2 (40%) and a Denis work scale score of W3 (46.7%), but in the short-segment group, most patients had scores of P3 (60%) and W4 (46.7%). We encountered no major complications.

Conclusion

While long-segment fixation provides greater stability, short-segment fixation results in less operative time and blood loss without compromising clinical outcomes. Longer follow-up studies with larger sample sizes are recommended.