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Korean J Spine Search

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Two Cases of Monosegmental Pedicle Screw Fixation for Thoraco-lumbar Fracture(Three-column Injury), and a Review of the Literature.
Ji Hoon Lee, Chan Woo Park, Chan Jong Yoo, Sang Gu Lee, Woo Kyung Kim
Department of Neurosurgery, Gachon University, Gil Medical Center, Incheon, Korea. chanwoo@gilhospital.com
Abstract
The management of thoraco-lumbar fractures remains controversial. Different authors have advocated immobilization, external bracing or internal fixation by either anterior or posterior approaches. To stabilize the fracture and avoid an unne cessary fixation of an uninjured segment, posterior monosegmental fixation was performed in Type B1 fractures according to the classification of Magerl et al, with nearly intact vertebral body for load support. Two patients underwent fixation with 4 titanium pedicle screws, one level above and directly into the fractured vertebra body. Patients had a stable fixation at 6 months following surgery. No patients experienced neurological deficit or had developed a delayed kyphotic deformity. Single level fixation for selected cases of thoracolumbar fracture(Type B1 fractures) may be considered as an effective procedure to obtain fixation and fusion. But it is necessary to get a further follow-up period, further cases and especially biomechanical support.
Keywords: Monosegmental fixation;Thoracolumbar fracture


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