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.