TY - JOUR
T1 - Does Instrumentation of the Fractured Level in Thoracolumbar Fixation Affect the Functional and Radiological Outcome?
AU - Mohammed, Riaz
AU - Carrasco, Roberto
AU - Verma, Rajat
AU - Mohammad, Saeed
AU - Siddique, Irfan
AU - Elmalky, Mahmoud
PY - 2021/2/3
Y1 - 2021/2/3
N2 - Study Design: Retrospective comparative study.Objectives: To compare radiological and functional outcomes of patients with fixation constructs utilizing pedicle screw stabilization at the fracture level (FL group) versus patients with non-fracture level (NFL group) fixation in single level fractures of thethoracolumbar junction (T11-L1).Methods: 53 patients of whom fracture level screw was used in 34 (FL group) were compared to 19 patients in NFL group.Radiological parameters analysed were sagittal index, bi-segmental kyphosis (Cobb) angle and degree of vertebral heightrestoration. Prospectively collected patient reported functional outcomes and post-operative complications were also studied.Stepwise regression analysis adjusted by age, gender and functional scores was performed to account for the small numbers andunequal sizes of the groups.Results: Back pain score was significantly lower in the FL group (P < 0.025). Core Outcome Measures Index scores and leg painscores, though low in the FL group, were not statistically significant. The regression analysis showed that the inclusion of thefracture-level screw was independently associated with a greater change in sagittal index and vertebral height restoration post-operatively. Sagittal index was maintained through to final follow up as well. The bi-segmental Cobb’s angle correction was notassociated with fracture-level screw construct. There was no significant difference between the groups for revision surgery, deepinfection, implant failure or length of hospital stay.Conclusion: The inclusion of the fracture-level pedicle screws in the fixation construct significantly improves the immediate andfinal measured radiological parameters, with improved functional scores in single level unstable vertebral fractures of thethoracolumbar junction.
AB - Study Design: Retrospective comparative study.Objectives: To compare radiological and functional outcomes of patients with fixation constructs utilizing pedicle screw stabilization at the fracture level (FL group) versus patients with non-fracture level (NFL group) fixation in single level fractures of thethoracolumbar junction (T11-L1).Methods: 53 patients of whom fracture level screw was used in 34 (FL group) were compared to 19 patients in NFL group.Radiological parameters analysed were sagittal index, bi-segmental kyphosis (Cobb) angle and degree of vertebral heightrestoration. Prospectively collected patient reported functional outcomes and post-operative complications were also studied.Stepwise regression analysis adjusted by age, gender and functional scores was performed to account for the small numbers andunequal sizes of the groups.Results: Back pain score was significantly lower in the FL group (P < 0.025). Core Outcome Measures Index scores and leg painscores, though low in the FL group, were not statistically significant. The regression analysis showed that the inclusion of thefracture-level screw was independently associated with a greater change in sagittal index and vertebral height restoration post-operatively. Sagittal index was maintained through to final follow up as well. The bi-segmental Cobb’s angle correction was notassociated with fracture-level screw construct. There was no significant difference between the groups for revision surgery, deepinfection, implant failure or length of hospital stay.Conclusion: The inclusion of the fracture-level pedicle screws in the fixation construct significantly improves the immediate andfinal measured radiological parameters, with improved functional scores in single level unstable vertebral fractures of thethoracolumbar junction.
U2 - 10.1177/2192568221991106
DO - 10.1177/2192568221991106
M3 - Article
SN - 2192-5682
JO - Global Spine Journal
JF - Global Spine Journal
ER -