Long-segment Fixation VS Short-segment Fixation Combined With Kyphoplasty for Osteoporotic Thoracolumbar Burst Fracture

Background: To compare clinical and radiological results of long-segment fixation (LF) and six-screw short-segment fixation combined with kyphoplasty (SSFK) for osteoporotic thoracolumbar burst fracture (OTBF). Methods: Forty patients affected by OTBF with mean age of 61.85 were included in this study. The mean follow-up period was 13.63 months. Twenty-four patients were treated by SSFK, and 16 patients were treated by LF. Clinical outcomes, radiological parameters and complications were assessed and compared. Results: The mean operative time and blood loss were 89.71±7.62min and 143.75±42.51ml for SFK group, respectively; 111.69±12.25min (P<0.01) and 259.38±49.05 ml (P<0.01) for LF group, respectively. The two groups were similar in terms of preoperative radiological and clinical results. Compared with preoperative values, both groups achieved significant improvement in terms of VAS, ODI, Cobb angle and anterior vertebral body height (AVH) ratio at final follow-up. However, during the follow-up period, the loss of Cobb angle and AVH ratio were significant different between immediately postoperative and final follow-up evaluations for both groups. Five cases (20.83%) of asymptomatic cement leakage were observed in SSFK group. One case of implant failure and two cases of adjacent or non-adjacent vertebral fractures were observed in LF group. Conclusions: For the treatment of OTBF, SSFK shows similar clinical and radiological results as LF. Comparatively, SSFK is less invasive and can preserve more motion segments, which is a more valuable surgical option in selected elderly patients.