الفهرس 
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Abstract
Our present study was conducted in the department of Orthopedics and traumatology, sohag university hospital, Sohag University during the period between January 2014 and July 2014.some cases were obtained retrospectively from the data base of the department.
Twenty patients with burst fracture at thoracolumbar junction managed operatively with short segment pedicle screws fixation during the course of the study were sorted and each was followed for at least 6 months.
Follow up of all patients were carried out regularly with clinical, neurological and radiological assessment till 6 months postoperatively. The data thus collected from patients was analyzed, evaluated, and the observations were recorded.
Our aim was to evaluate the result of short segment fixation in treatment of burst fractures of thoracolumbar spine (type A3 according to AO classification).
All the patients were examined clinically, neurologically and radiological, including detail history of pre morbid status at the time of admission. Patients fulfilling the inclusion criteria was only included in the study.
Mean age in years was 31. There was a male preponderance in our patients. A male to female ratio in all patients was about 3:1.
Most common mode of injury was falling from height about 65% of all cases most of them were males due to daily activities and hard works.
In this study, we had 8 cases (40%) with burst fracture at L1, 6 cases (30%) at L2, 5 cases (25%) at Th 12 and only one case with burst fracture at L1&Th12.
In present study series, eight patients had associated injuries (40%); three cases had fracture calcaneus, three cases had fractures in the upper limbs, one case had fracture scapula and one case had pylon fracture.
Most of the patients were operated at the emergency unit within the 1st day of admission in the hospital (75%). While the rest of the patients (25%) operative procedure was delayed either due to medical problem or due to financial constraints.
Majority of patients in present study series were neurologically free preoperatively 13 cases (65%). four cases with neurological affection preoperatively were improved (20%) , two case were Frankle C&D still the same(10%) and the last one deteriorated from Frankle B and became Frankle A(5%).
Preoperatively; 2 patients were found to have chest infection, as they were chronic smoker,4 patients were found to have diabetes mellitus, one case of them had diabetic ketoacidosis postoperatively and admitted in the department of internal medicine to control blood glucose level, ischemic heart disease was in 3 patients and Stress hypertension noted in many patients.
Superficial would infection was seen in one case. She was a female patient, diabetic and was a fatty woman.no deaths occurred in our study.
Transpedicular fixation and decompression was needed in 7 cases (35%) because they were suffering from neurological insult.
There was marked improvement in vertebral height loss. Average preoperative percentage of vertebral body height loss was 36.8%, which improved to 17.6% at final follow-up.
In our study series, according to modified Oswestry Low BackPain Disability scoring system there were 10 cases(50%) with Minimal disability; they can cope with most living activities, 6 cases(30%) with moderate disability and the back condition can usually be managed by conservative means and 3cases (15%)with sever disability and strong analgesics was needed
only one case(5%) was Crippled .
Two cases (10%) had metal failure in the form of knot migration and backing out of the rods.one of them was Frankle B and deteriorated to Frankle A. removal of the implant occur after 3months.
The other case was female patient with Frankle D and improved to Frankle E postoperatively, and she didn’t remove the implant.
One case (5%) had deep infection in his leg because he had pylon fracture, debridement and removal of the implant was done and two cases (10%) had dural tear.
Angle of kyphosis was measured by Cobb method preoperatively and at the last visit.
Mean kyphotic angle preoperative was= 19.50 and post operative mean angle =10.150.
mean follow up period was 8.55+_3.38 ranging (6-20 ms).
CONCLUSION
Posterior short segment pedicle screw fixation is good and enough for treatment of burst fracture of thoracolumbar spine when neurological condition of the patients is intact. But if the neurological condition of the patients is affected and decompression of spinal canal is needed, it is better to do long segment fixation to achieve good stability and prevent metal failure , progressive kyphosis and vertebral collapse.