Radiologic and Functional Outcomes in Unstable Thoracolumbar Fractures Treated With Short-segment Pedicle Instrumentation.

STUDY

DESIGN

A retrospective review of radiographs, clinical charts, and health questionnaires of 40 patients.

OBJECTIVE

To evaluate the radiologic and functional results of unstable thoracolumbar fractures treated with short-segment pedicle instrumentation (SSPI).

A SUMMARY OF BACKGROUND DATA: Although earlier publications report a risk of correction loss or material failure after short-segment fixation in unstable thoracolumbar fractures, more current data suggest that improvements in this technique could offer good clinical and radiologic results.

MATERIALS AND

METHODS

We undertook a retrospective review of 40 patients with unstable thoracolumbar fractures treated with SSPI. Radiographs and computed tomogrphic scans were analyzed to determine fracture classification and sagittal plane deformity, estimated by the Cobb method. The rates of final kyphosis and correction loss and their relationship with the Load Sharing Classification (LSC) and the AO classification were analyzed. We reviewed the hospital charts to identify complications and outcomes. At the final follow-up, the Short-Form 36 health survey was carried out to evaluate the functional outcome. The relationship between conditions such as polytrauma, neurological compromise or fracture site, and radiological and functional outcomes was also analyzed.

RESULTS

We observed mean values of 5.9 degrees of final follow-up kyphosis and 5.1 degrees of correction loss. One case of material failure was seen. The severity in the LSC or the AO classification, polytrauma, neurological compromise, or fracture site had no relationship with worse radiologic or functional outcomes.

CONCLUSIONS

SSPI shows good results in fracture reduction, with good functional outcomes despite the loss of correction seen at the final follow-up. Although no investigated variable was found to be predictive of radiographic failure, a trend was identified (P=0.07) that patients with a higher LSC had an increased loss of correction.