Long-Term Reliability of the Two-Segment Fusion Technique in the Treatment of Thoracolumbar Fractures Using Screws in the Fractured Vertebra

(A) Measurement technique of vertebral, regional and thoracolumbar kyphosis on x-ray. VK (19°): angle based on a tangential line to the superior and inferior end plate of fractured vertebra. RK (7°): angle based on a tangential line at the superior edge of the superior vertebra and a tangential line at the inferior edge of the inferior vertebra. TLK (12°): angle based on a tangential line at the superior edge of T10 and a tangential line at the inferior edge of L2. (B, C) Axial and sagittal CT images that suggest a type A2 burst fracture according to AO classification. We can also perform the measurement technique on sagittal CT images. (D) Indirect initial reduction with patient positioned in prone decubitus. (VK 8°, RK 4°). (E) Fractured vertebra instrumented with cannulated screws on both pedicles toward the lower vertebral plate. (F, G) The placement of the slightly molded bars in lordosis and its union to the screw allowed for an adequate correction with indirect reduction of its deformity (VK 4°, RK 1°). (H) X-ray image at the end of follow-up (8 years after surgery). A long-term progression of VK, RK, and TLK is observed (TLK 22°, RK 16°, and VK 13°). VK indicates vertebral kyphosis; RK, regional kyphosis; TLK, thoracolumbar kyphosis; CT, computed tomography.