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COMPARISON OF SHORT SEGMENT TRANSPEDICULAR SCREVVS AND LONG SEGMENT HOOK APPLICATIONS WITH RESPECT TO STABILISATION, CORRECTION AND INDIRECT CANAL DECOMPRESSION ABILITIES İN THE TREATMENT OF BURST FRACTURES OF LUMBAR VERTEBRAE

  • Vasfi KARATOSUN
  • Hasan Can KÖSEOĞL
  • Ceyhun BALCI
  • Hasan Hüseyin ERSOY
  • Özer ÜLKÜ

J Turk Spinal Surg 1997;8(2):69-77

The purpoSe of this study is, to investigate and to compare the interrelation between stabilisatîon achievement, correction ability, indirect medullary decompression and indirect medullary decompression achievement in cases of lumbar burst (L1, L2, L2) fractures treated with short segment transpedicuiar screw fixation (SSTS) and iong segment hook applications (LSH).

Patients were divided into two groups. İn Group 1, there were 17 patients who were treated with Short Segment Transpedicuiar Screw (SSTS) and in Group 2 there were 27 patients treated with Long Segment Hook (LSH) applications. Distribution of lesion levels in Group 1-SSTS and Group 2-LSH were L1: 6-17, L2: 5-8, and L3: 6-2, respectively. Mean follow-up in Group 1-SSTS and Group 2-LSH were 40 months (not less then 30 months) and 46 months (not less than 12 months), respectively. Mean age was 31.6 in Group 1-SSTS and was 33,8, in Group 2-LSH. İn both groups stabilisation was performed by Alıcı Spinal System.

Cases were evaluated according to their loss of anterior vertebral height, anterior compression angle and local kyphyosis angle in plain radiographs (preoperatively, postoperatively and follow-up) and medullary encroachment in preoperative andpostoperative CAT-scans.

Therefore, we conclude that: (1) Alıcı Spinal System and posterior instrumentation is sufficient in stabilisation and restoration of lumbar burst fracture. (2) İn posterior instrumentation of lumbar burst fractures Group 1-SSTS and Group 2-LSH have no superiority to each other. (3) Aiso, medullary decompression and stabilisation abilities of Group 1-SSTS and Group 2-LSH have no superiority to each other. (4) Although performance of medullary decompression decreases with the delay of operation, statistically we haven't seen significant difference, in both groups. (5) İt is very important to verify the status of posterior longitudinal ligament by MRI prior to indirect canal decompression. (6) There was no significant difference between two groups with respect to complications. (7) There was no difference between two methods in order to give permission early mobilisation, (8) Both methods have equal capability of returning daily activity and previous work. Also, pain in the follow-up didn't show difference in both groups.

Keywords: Lumbar Vertebrae, Burst Fracture, Short Segment Pedicular Screw, Long Segment Hook, Stabilisation, Correction, İndirect Canal Decompression