Mid-to long-term outcomes of different fusion strategies in short-segment fixation for 242 cases of thoracolumbar fractures
Wu Jian
Gan Yibo
Liu Yaoyao
Zhu Jun
Wang Yingbo
Pu Jungang
Liu Baiyi
Wang Dongsheng
Liu Peng
Abstract：Objective To compare the mid-to long-term outcomes of different fusion strategies in short-segment fixation for patients with thoracolumbar fractures.Methods A retrospective analysis was conducted on 242 patients with single-segment thoracolumbar fractures who underwent short-segment posterior fixation at our depart-ment from Jun.2017 to Aug.2024,with a minimal follow-up period of one year.Among them,147 were male and 95 were female,aged 17-59 years,with a mean age of 45.6 years.The injury causes included falls in 197 cases,road traffic injuries in 32 cases,and others in 13 cases.Based on the intraoperative fusion strategies,patients were divid-ed into non-fusion group(190 cases),partial fusion group(37 cases),or total fusion group(15 cases).Patients in the three groups were comparable in terms of general data and injury severity(P＞0.05).The oswestry disability in-dex(ODI),visual analog scale(VAS)score,the 36-item short form health survey(SF-36)scores,and hospital anxiety and depression scale(HADS-A and HADS-D)scores were recorded preoperatively and at the final follow-up.Surgery-related complications within 90 d after surgery,operative time,intraoperative blood loss,and hospital stay were compared among the three groups.Results The non-fusion,partial,and total fusion groups were followed up for respectively(62.7±25.4),(58.1±23.4),and(60.0±33.1)months,revealing no significant differences(P＞0.05).At the final follow-up,the abovementioned three groups showed the VAS scores of 1.5±0.7,1.7±0.8,and 1.5±0.5;ODI of 8.1%±3.2%,7.3%±2.8%and 7.7%±3.5%,SF-36 scores of 87.9±2.1,78.6±1.6 and 78.9±1.2;HADS-A scores of 1.5±0.6,1.4±0.6 and 1.4±0.5;and HADS-D scores of 0.1±0.3,0.2±0.4,0.1±0.4,significantly improvement compared to the preoperative values(all P＜0.05);however,comparison between the three groups revealed no significant differencs(All P＞0.05).But the non-fusion group reported much less opera-tion time(min,110.1±34.1)and intraoperative blood loss(mL,111.7±72.1)than the partial fusion group[(124.7±41.2)min,(171.6±123.0)mL]and the total fusion group[(128.3±31.2)min,(160.0±66.4)mL](all P＜0.05).Conclusion For single-segment thoracolumbar fractures without significant deformity,severe dis-placement,or neurological injuries,short-segment posterior fixation provides similar mid-to long-term functional and psychological improvement.The non-fusion technique leads to much shorter operation time and less intraoperative blood loss,therefore,being a commendable treatment option for such patients.
Keywords：Thoracolumbar fracturesFusionQuality of lifePsychological status
Publication Date：2026-02-15
Online Publishing Date：2026-03-23(First online date of this platform, not the publication date of the document)
Pages：6( 99-104 )