Abstract

Objective: To compare the outcome of posterior short segment fixation with bony fusion and without bony fusion in thoracolumbar fractures in the first year of follow up.
Methodology: A comparative study was conducted in Orthopedic Department of Lahore General Hospital, Lahore, Pakistan for one year. Twenty eight cases were randomly included and divided into two Groups consisting of 14 cases each. Group A had posterior short segment fixation with bony fusion while bony fusion was not performed in Group B. Kyphosis angle measurement by Cobb’s Method was carried out in all the cases both preoperatively and immediately after the procedure. This measurement was repeated at follow up visits at 3 months, 6 months and 12 months and kyphosis correction loss was calculated along with percentage of the loss.
Results: The mean age of patients was 30.89±6.40 years. There were 23 (82%) males while 5 (18%) were females. The male-to-female ratio was calculated as 4.6:1. Overall kyphosis angle was 27.36±7.87,o which improved to 2.93±5.73o after surgery. The mean correction in kyphosis angle was 24.29±4.20o and after 12 months, the loss of correction was 10.25±2.90o. Preoperatively, in fusion group, the mean kyphosis angle was 26.00±7.910 while in non-fusion group; it was 28.71±7.870. After surgery, mean correction in fusion group was 23.71±3.97o with loss of 9.93±2.62o after 12 months. There was 41.89% loss of correction observed in this group. While in non-fusion group mean correction was 25.07±4.46o with loss of 10.57±3.23o after 12 months, which is 42.16% loss of correction.
Conclusion: Posterior short segment instrumentation without fusion was a better option for treating the thoracolumbar fractures.

Key words: Spinal fractures, transpedicular fixation, posterior fusion.