Comparison of Clinical and Radiological Evaluations for the Management of Lumbar Fractures between Short and Long Fusion Segments

Abstract

Background: The evolution of the transpedicular screw fusion system has facilitated the adoption of a short fusion segment (This procedure entails the immobilization of a single intact vertebra both superiorly and inferiorly to the affected region) as a viable and prevalent alternative to a long fusion segment (This procedure entails the stabilization of two adjacent non-affected vertebrae, situated superior and inferior to the traumatized region) in regular clinical practice. To assess and contrast the impact of them for the treatment of lumbar fractures, both of which have shown efficacy. However, a matter of controversy persists regarding the superiority between them. Methods: A comprehensive analysis of all lumbar fractures that were managed surgically between February 2018 and March 2020 for a duration of two years was undertaken at Paky Hospital. A collective of 42 patients with lumbar spine fractures were segregated into two distinct groups. Group A (short fusion segment) comprised of twenty-one patients, whereas Group B (long fusion segment) consisted of twenty-one patients. Results: Transpedicular fixation was carried out in a total of 42 instances, comprising 26 patients of the male gender and 16 of the female gender, with a gender ratio of male-to-female 1.8;1 person. Most of the patients belonged to the age bracket between 20 to 60 years. The severity of injuries varied among various age cohorts. Injuries are highly predominant at the L1-L2 vertebral level, where compression fractures represent the majority, accounting for 36 cases (85%) of all fractures. The assessment of the outcomes was carried out utilizing Frankel’s categorization, the degree of kyphotic deformity in the spinal column, and the height of the body of the vertebrae. None of the patients manifested heightened neurological deficits. Most of the cases demonstrated a progression to the succeeding stage. While the pre-operative kyphotic deformation of the vertebral body amounted to 29.1±4.4 and 27.3 ± 3.4 in groups A and B, correspondingly. No discernible contrast in statistical significance was observed between group A and group B in terms of the kyphotic deformation after the operation of the vertebral body, with group A having a measurement of 11.0±2.7 and group B having a measurement of 9.9±1.8 (P>0.05). Conclusion: According to the findings of this investigation, traumatic injuries to the lumbar spine can be treated through spinal fusion utilizing a posterior approach. Both the short and long fusion segments were found to be efficacious in treating such injuries. These approaches aid in neurological recuperation, mitigate pain, and better the status of disability through early rehabilitation. This is achieved even without any noteworthy radiological distinctions when evaluated over the short term