The biomechanics of reduction and loss of correction of the burst fractures treated with transpedicular systems have not been adequately investigated. There are a wide range of conditions that can cause instability of the thoracolumbar spine after transpedicular fixation. One of the most important situation is proper Insertion of the screw through the pedicle.
A total of 87 patients with unstable burst fractures of the thoracal, thoracolumbar and lumbar spine were treated with posterior spinal instrumentation (Alıcı; 45, Isola; 30, AO Spinal Internal Fixator; 12). Ali patients were evaluated pre and postoperatively with plain radiographs and computed tomography.
The average follow up was 2.4 years and patients had an average 11° loss of correction in local kyphotic angle.
İn 20 of patients inproper insertion of the pedicular screw was observed and we observed an average 13° of loss of correction in local kyphosis angle. İn the cases that had proper pedicular screw insertion, there was an average 5° loss of correction, and thı's was statistically significant (p<0.05).
This clinical study emphasized the importance of the proper insertion of pedicular screw during spinal trauma surgery. This influences the results both mechanically and neurologically.
Keywords: Spinal fracture, transpedicular fixation.