ACTA FAC MED NAISS 2010; 27 (2): 63-68

Original article

UDC: 616.711-001.5-089 

Transpedicular Screw Fixation of Thoracolumbar Spine Fractures

 

Saša Milenković¹, Jordan Saveski², Neda Trajkovska², Goran Vidić¹, Mile Radenković<sup>1

1</sup>University Orthopaedic and Traumatology Clinic Niš, Serbia

²University Traumatology Clinic Skoplje, Macedonia

SUMMARY

Thoracolumbar spine fractures are most common in the young healthy population. The most common causes of these fractures are high-energy traumas, traffic accidents or falls from heights. Fractures can be followed by neurological damage, which is a dir-ect consequence of the spinal cord damage. Fractures are treated with surgical or non-surgical methods. The best results can be obtained by surgical treatment. Transpedicu-lar screw fixation is one of the methods of surgical treatment. The aim of the paper was to evaluate the initial results of the application of the posterior transpedicular screw fixation in the treatment of unstable fractures of the thoracolumbar spine segment, without neurologic injury. Patients were operated on at the Orthopaedic and Traumatology Clinic Niš and in the Traumatology Clinic Skopje. Fractures were classified according to the AO classification. The severity of the injury was determined by means of Thoracolumbar Injury Severity Scale - TLISS. Two types of the internal fixator for the transpedicular srew fixation, Expidium (Johnson&Johnson) and Xya (Stryker) were used for the frac-ture fixation. The paper presents the results of the transpedicular screw fixations of the thora-cic and lumbar vertebrae in 16 patients, with mean age 45.06 years. There were three patients with Th 12 fractures, five patients with L1 fracture, seven patients with L2 fracture and one patient with L4 vertebral fracture. There were five fractures of A2 type and eight fractures of A3 type. We had one patient with B1 fracture and two patients with B2 fracture. There was one mechanical complication and one superficial infection in an early phase of post-operative recovery. The mean follow-up period was 14.12 months. The final functional results were good in all patients. By applying the transpedicular screw fixation of the unstable fractures of the thoracolumbar spine segment, a stable fracture fixation can be accomplished, that is, by applying distraction or ligamentotaxis, medular canal decompression is achieved. This kind of fixation prevents the possibility of the occurrence of secondary spine deformities and enables quick recovery of surgically treated patients.

Key words: transpedicular screw fixation, thoracolumbar fractures