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SICOT J. 2019;5:42. doi: 10.1051/sicotj/2019039. Epub 2019 Nov 29.

A comparative study between the Universal Spinal System® (USS) and the CD Horizon® Legacy™ (CDH) in the management of thoracolumbar fractures.

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Orthopedics and Traumatology Department, Faculty of Medicine, Cairo University, Kasr Al Ainy Street, Cairo 11562, Egypt.
Orthopedic Department, Spine Surgery Unit, Al-Razi Hospital, Block 1, Jamal Abdul Nasser Street, Kuwait City, State of Kuwait.



For the treatment of unstable non-osteoporotic thoracolumbar fractures, the clinical and radiological outcome of short-segment fixation with the USS™ - Universal Spine System (DePuy Orthopedics, Inc., Warsaw, IN, USA) and the CD HORIZON® LEGACY™ 5.5 Spinal System, (Medtronic Sofamor Danek USA, Inc., Memphis, TN, USA) were compared.


From March 2015 to January 2016, 40 consecutive patients with unstable traumatic thoracolumbar fractures who met our inclusion criteria were treated with either the USS system or CDH Legacy system. Segmental kyphosis angle (SKA) and anterior body height (ABH) of fractured vertebrae, and ASIA Impairment Scale (AIS) were evaluated. Radiological fusion was confirmed with plain X-rays and when indicated with computerized tomography (CT).


The mean immediate kyphotic angle correction was 16.6° for the Schanz and 6.4 for the Legacy system, and the immediate mean anterior vertebral body height correction was 0.92 cm for the Schanz and 0.51 cm for the Legacy system. Our study shows a significant statistical difference between Schanz and Legacy systems regarding post-operative segmental kyphosis and height correction immediately postoperatively, at 6 months and at one-year follow-up (p-value < 0.005). The degree of pain reduction and neurological improvement was not influenced by the screw system.


Usage of USS in thoracolumbar fracture as a short-segment fixation led to a near anatomical reduction when compared to the Legacy system. However, there was no advantage regarding pain reduction and neurological outcome.


CDH LEGACY; Pedicle screw; Polyaxial; Short-segment fixation; Thoracolumbar burst fractures; USS Universal Spine System

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