TY - JOUR ID - TI - Short Segment Posterior Instrumentation with Intermediate Screw in Thoracolumbar Junction Injury: Prospective Study AU - Karam Fawaz Aldarzi , Walid W. Al-Rawi PY - 2021 VL - 20 IS - 2 SP - 116 EP - 127 JO - Iraqi Postgraduate Medical Journal المجلة العراقية للاختصاصات الطبية SN - 83601608 98932708 AB - 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 atfracture site makes it more stable with a better clinical outcome.OBJECTIVE:The aim was to evaluate the radiological and clinical parameters of posterior shortsegment fixation with intermediate screw implantation into the fractured vertebra.METHODS:We evaluated 30 patients with unstable thoracolumbar fractures, managed with shortsegment posterior instrumentation with intermediate screw in the fractured vertebra; fracturesclassification was done according to AOspine and TLICS systems . Eighteen male and 12 femalesqualified for the study; male to female ratio was 1.5:1; average age 28.86 years. Neurological statuswas classified according to the ASIA impairment scale. Pain was evaluated by VAS score. Thepercentage 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 finalfollow up. Preoperative mean vertebral body collapse was 48.40%, which had significantly improvedto 12.85% at final follow up. Mean segmental kyphotic angle was 21.83° before surgery, final meansegmental kyphosis was 8.63°. Fifteen patients with incomplete neurologic deficits had improvementby at least one ASIA grade on final follow-up observation, and 2 of 4 patients with completeneurologic deficit remained unchanged. All neurologically intact patients remained unchanged. Noneof patients had implant failure.CONCLUSION:Short segment fixation with intermediate screws in treatment of thoracolumbar junctionfracture effectively improve stability with most of patients achieve significant improvement in clinicaloutcomes.

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