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Unilateral Pediculectomy and Reduction with Short-Segment Pedicle Screw Fixation for Thoracolumbar Burst Fracture: A Case Series

Authors
Lee, Sang HyubLee, SubumJang, Sun WooShin, Hong KyungKim, Dong-HwanKang, Dong HoJeon, Sang RyongRoh, Sung WooPark, Jin Hoon
Issue Date
Dec-2023
Publisher
Elsevier Inc.
Keywords
Case series; Pediculectomy; Post-traumatic kyphosis; Short-segment fixation; Spine trauma; Thoracolumbar burst fracture
Citation
World Neurosurgery
Indexed
SCIE
SCOPUS
Journal Title
World Neurosurgery
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/69744
DOI
10.1016/j.wneu.2023.11.134
ISSN
1878-8750
1878-8769
Abstract
Background: This study aimed to evaluate the efficacy of unilateral pediculectomy and reduction with short-segment pedicle screw fixation for thoracolumbar burst fracture. Methods: We retrospectively reviewed patients who underwent a unilateral pediculectomy and reduction with short-segment fixation and interbody fusion for thoracolumbar burst fracture. The unilateral pediculectomy created sufficient space to approach the ventral side of the spinal cord for removing bone fragments and insertion of an interbody cage to correct kyphosis. Lumbar lordosis (LL), pelvic incidence (PI) minus LL, and segmental Cobb angle were measured at 3 time points: preoperatively, postoperatively, and final follow-up. Furthermore, sagittal vertical axis (SVA) was measured to assess global sagittal balance at the final follow-up. Results: A total of 10 patients, with a mean age of 39.8 ± 21.0, underwent the surgical procedure. All patients had a thoracolumbar injury classification and severity score > 5. The mean follow-up period was 15.8 ± 13.9 months. The mean postoperative LL (46.0 ± 5.8) was significantly higher (P = 0.008) than the preoperative measurement (32.8 ± 8.2). The mean postoperative PI minus LL (2.2 ± 8.4) was not significantly lower (P = 0.051) than preoperative measurement (15.4 ± 12.6). The mean postoperative segmental Cobb angle (11.4 ± 8.4) was significantly higher (P < 0.001) than the preoperative measurement (−11.6 ± 10.9). At the final follow-up, the mean sagittal vertical axiswas 10.0 ± 28.8 mm. Conclusions: Unilateral pediculectomy and reduction with short-segment fixation and interbody fusion served as an efficient surgical method for thoracolumbar burst fracture. © 2023
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