Comparison of Methods for Short-Segment Posterior Stabilization of Lumbar Spine Fractures and Thoracolumbar Junction

腰椎骨折和胸腰段骨折短节段后路固定术方法比较

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Abstract

Background: Thoracolumbar and lumbar spine injuries account for 30-60% of spinal fractures, especially at the thoracolumbar junction. Conservative treatment is recommended for stable fractures without neurological symptoms, but studies suggest surgical intervention may offer better outcomes. However, there is no consensus on the best stabilization method. Methods: This non-randomized, prospective study was conducted on 114 patients divided into groups based on the surgical technique selected: pedicle stabilization using Schanz screw constructs (Group One, n = 37) stabilization above and below the fractured vertebra using pedicle screws (Group Two, n = 32), and intermediate fixation with a pedicle screw additionally inserted into the fractured vertebra (Group Three, n = 45). Outcomes were assessed using the Cobb angle, anterior and posterior vertebral wall height, and patient quality of life via the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). X-ray imaging was performed before, during, and after surgery in the control group. Results: This statistical study showed that the location and type of injury significantly influenced the choice of short-segment stabilization method. In the case of measuring the Cobb angle and the high anterior wall, the statistical analysis showed that the best result was observed in the Schanz Group. Patients from this study group had the lowest pain and the highest efficiency. Conclusions: Schanz screw stabilization may offer superior outcomes for thoracolumbar spine injuries, providing better clinical and quality of life results compared to other methods.

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