Posterior short-segment fixation with transforaminal lumbar interbody fusion for the treatment of unstable lower lumbar fracture

Background: The objective of this study was to evaluate the clinical and radiographic results of posterior short-segment pedicle screw fixation and transforaminal lumbar interbody fusion (TLIF) in selected types of lower lumbar fractures. Methods: Twenty-seven patients with lower lumbar fractures were enrolled in this study. Demographic data, neurologic grade, anterior vertebral body heights, vertebral body translation, segmental Cobb angle, and management-related complications were assessed. The minimum follow-up period was 2 yr. Results: Twenty male patients and seven female patients underwent the procedure, with a mean operative time of 182 min. Mean blood loss was 588 mL. The mean preoperative local kyphotic angle was 9.5 degrees that improved to 2.5 degrees postoperatively. The loss of correction was insignificant at the final follow-up. The preoperative percentage of height lost improved from a mean of 52.5% to a mean of 89.05% postoperatively, and at last follow-up no loss of correction in height was noted compared to the postoperative results. No pseudarthrosis or metal failure was detected. All patients who were Frankle E on admission remained neurologically intact. Conclusions: Posterior short-segment fixation with pedicle screw fixation augmented with TLIF might be a possible choice for selected patients with unstable lower lumbar fractures, particularly in split fractures, burst fractures with a reversed cortex sign, and traumatic spondylolisthesis.