Vertebral body spread in thoracolumbar burst fractures can predict posterior construct failure.

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Abstract

[Indexed for MEDLINE] 3. Injury. 2017 Aug;48(8):1806-1812. doi: 10.1016/j.injury.2017.06.015. Epub 2017 Jun 20. Additional vertebral augmentation with posterior instrumentation for unstable thoracolumbar burst fractures. Kao FC(1), Hsieh MK(2), Yu CW(1), Tsai TT(1), Lai PL(1), Niu CC(1), Chen LH(1), Chen WJ(1). Author information: (1)Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan. (2)Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan. Electronic address: stock-best@yahoo.com.tw. BACKGROUND: To investigate the role of vertebral augmentation in kyphosis reduction, vertebral fracture union, and correction loss after surgical management of thoracolumbar burst fracture. DESIGN: Retrospective chart and radiographic review. SETTING: Level 1 trauma center. METHODS: The analysis included patients treated between April 2007 and June 2015, who received pedicle-screw-rod distraction and reduction within two days following acute traumatic thoracolumbar burst fracture with a load sharing score >6. Medical records were retrospectively reviewed for data regarding operative details, imaging and laboratory findings, neurological function, and functional outcomes. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Sagittal index, pain score, loss of correction, and implant failure rate. RESULTS: Nineteen patients were enrolled in this study (mean age, 37.2±13years; age range, 17-62 years; female/male ratio: 10/9). Of the five patients who received only reduction (no augmentation), one underwent revision surgery because of implant failure and pedicle screw backing out. Compared to patients who received only reduction, those who received both reduction and augmentation showed better sagittal alignment after the operation, with better sagittal index immediately postoperatively and during the follow-up (p