Comparative Study of Short Segment Fixation with or Without Transpedicular Bone Graft for Surgical Treatment of Burst Fractures of Thoracic and Lumbar Spine in Adults After Trauma

Abstract

Background And Objective: Thoracolumbar fractures are among the most common fractures of the spine
because of high energy trauma. A short segment fixation with two proximal & two distal screw fixation
including the fractured vertebra at single level thoracolumbar fracture with or without transpedicular
intracorporeal bone graft provides the adequate support & stability. The objective of this study was to assess
the clinical effectiveness of short segment fixation with or without transpedicular bone grafting substitutes in
patients with single level Thoracolumbar spine Burst fracture.
Methods: This Randomized Controlled Trial was conducted from December 2016 to December 2019 in the
Department of Orthopedic & Spine Surgery at Lahore General Hospital, Lahore. After approval from Hospital
Ethical Review Board, 64 patients having single level burst fractures of thoracolumbar Spine were divided
into two equal groups A & B. In Group A, all patients were treated with short segment trans pedicle screw
fixation with bone graft while in group B patients, only short segment fixation was done. All the patients were
followed for one year to assess the Kyphotic angle, vertebral body height and visual analogue score (VAS)
and was noted in a predesigned proforma.
Results: Group A and Group B demonstrated statistically significant differences in various measured
outcomes. For the kyphotic angle, Group A recorded a mean of 18.5° ± 4.0°, while Group B had a slightly
higher mean of 19.5° ± 4.2° (p = 0.03). Vertebral height measurements revealed that Group A maintained a
mean height of 23.1 ± 2.8 mm, whereas Group B exhibited a lower mean height of 21.3 ± 3.3 mm (p = 0.02).
Lastly, the VAS score, reflecting pain intensity, showed Group Awith a mean score of 2.0 ± 0.8, slightly lower
than Group B's 2.05 ± 0.7 (p = 0.01), indicating a statistically significant improvement in pain levels in both
groups but more significant in Group Aover the year.
Conclusion: Short Segment Fixation is an effective treatment option for maintaining the anterior vertebral
height and prevention of loss of kyphotic angle at single level thoracolumbar fracture of the spine. Moreover,
the VAS score was also improved where the short segment fixation with transpedicular bone graft was done.