Hartshill fixation system or pedicle screw fixation system? - a retrospective comparative study of posterior spinal fixation methods

Spine injuries is a serious medical condition that has a major impact on the quality of life of the patient. Although there is a varying consensus among treating physicians, surgical fixation of a traumatic fracture of the thoracic or lumbar spine is considered necessary if axial and rotational stability is severely impaired or if a neurologic deficit is present or imminent. Considerable controversy exists regarding the clinical performance of different instrumentation systems for the surgical treatment of unstable fractures of the thoracolumbar spine. Although the biomechamical performance of different spinal fixation devices has been studied extensively in the laboratory, comparative clinical outcome data are few. This paper compares the different posterior internal fixation devices. Hartshill (based on sublaminar wiring to gain purchase on posterior column structures alone) and pedicle screw fixation (in which all three spinal columns may be controlled directly and are able to reduce fractures of these columns by ligamentotaxis).  The aim of this study is to compare the efficacy of the Hartshill system and newer pedicle screw rod systems.  Case records of 30 patients of thoracolumbar spine fractures with incomplete neurological deficit who were operated for decompression and posterior spinal fixation were included in this study. They were divided in two groups of 15 each, Group 1 (Hartshill fixation) and group 2 (Pedicle screw fixation). Analysis of the case records was done for comparison of the two systems with respect to the operative time, blood loss, complications, loss of correction and mobility status at follow up in the treatment of thoracolumbar spine fractures.