Whether patients with load sharing classification (LSC) score ≤ 6 need the additional screws in the fractured vertebra?: a prospective randomized study with 2 years of follow up.

研究概要

150 patients with thoracolumbar burst fractures and an LSC score ≤6 were randomized to undergo posterior short-segment pedicle fixation with injured vertebra fixation (PSPFI) or posterior short-segment pedicle fixation without injured vertebra fixation (PSPF). The outcomes of interest were radiographic parameters, including intervertebral disc height (IDH), anterior vertebral height (AVH), Cobb angle, and loss of correction during follow-up. Other outcomes includeded the Oswestry Disability Index (ODI), visual analogue scale (VAS) pain scores, operative time, blood loss, hospital stay, ambulation time, and complications. Outcomes were assessed preoperatively, at 1 week postoperatively, and at 24 months. Overall, the results of the study revealed that both techniques achieved significant radiographic correction and clinical improvement with comparable long-term outcomes. Although PSPFI demonstrated slightly better maintenance of correction, PSPF resulted in shorter operative time and less blood loss. These findings suggest that routine placement of additional screws in the fractured vertebra may not be necessary for patients with an LSC score ≤6.