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Length of construct and cement augmentation

In patients requiring posterior lateral decompression, not requiring anterior column reconstruction, bilateral posterior pedicle screw fixation fixation with minimum fixation of at least one level above and below the involved segment should be used.

Short segment constructs lead to increased stress on the posterior implants increasing the risk of implant failure (screw pullout/fracture). The risk of implant failure may be decreased by cement augmentation of fenestrated screws and through reconstitution of the anterior column using cement augmentation of the pathological fracture.

Fixation of multiple spinal segments does not affect functionality in the thoracic spine due to the presence of rigid rib cage. Adequate screw purchase should be aimed for during initial surgery as revision surgeries are too demanding for these patients.