Surgical outcomes of short-segment fixation for thoracolumbar fracture dislocation.

BACKGROUND: Currently long-segment pedicle instrumentation for a thoracolumbar (T-L) fracture-dislocation is gaining in popularity. Otherwise, short-segment fixation may be chosen as an another treatment method. This article evaluates the efficacy and complications of short-segment fixation for the treatment of thoracic or lumbar spine fracture-dislocation. METHODS: Twenty patients with thoracic or lumbar spine fracture-dislocation were included in the study. The mean follow-up period was 3 years. Clinical, neurologic, radiologic (angle of deformity, displacement percentage, fusion rate), and complication outcomes were analyzed retrospectively. RESULTS: The rate of failure, defined as an increase of 10" or more in local kyphosis, an increase of 10% or more in displacement percentage, the development of pseudarthrosis, and/or implant failure, was analyzed. Short-segment instrumentation had a higher failure rate in the lower lumbar region (L3-L5) and a lower rate at the thoracolumbar junction (T11-L2). CONCLUSION: Thoracolumbar fracture-dislocation required firmer fixation especially in the low lumbar region, and short-segment fixation resulted in a high failure rate. Circumferential anterior and posterior fusion often played a role in certain severely injured cases. Good postoperative spinal alignment is crucial to a good outcome.