Which sufferers danger segmental kyphosis after brief section thoracolumbar fracture fixation with intermediate screws?
Harm. 2016 Oct;47 Suppl four:S29-S34
Authors: Formica M, Cavagnaro L, Basso M, Zanirato A, Felli L, Formica C, Di Martino A
INTRODUCTION: Using intermediate screws in fractured vertebrae has been proposed to lower the variety of fused ranges in thoracolumbar fractures and to allow brief fixations. The intention of this examine was to guage the outcomes of this system and to determine predictive components concerned in lack of segmental kyphosis correction (LKC).
METHODS: Forty-three sufferers who underwent short-segment spinal fixation with intermediate screws for a thoracolumbar backbone fracture in a two-year time interval have been enrolled within the examine. Sufferers had AO-type A3, A4 and B2 thoracolumbar fractures. Radiological parameters included segmental kyphosis (SK), vertebral wedge angle (VWA) and lack of anterior and posterior vertebral physique top. Sufferers have been evaluated as much as one-year follow-up. The correlation between LKC and potential danger components, comparable to smoking behavior, intercourse, age, neurological standing and BMI was evaluated.
RESULTS: Imply preoperative SK was 16.5°±6.5°, and it decreased to three.four°±three.5° postoperatively (P<zero.01). On the one-year follow-up imply SK dropped to five.5°±three.9° (P<zero.01). Imply preoperative VWA was 20.zero°±eight.1°, and considerably improved to six.three°±three.1° after surgical procedure (P<zero.01). There was a imply LKC of 1.eight°±2.1°at one 12 months. LKC mildly correlated with physique mass index (BMI, r: +zero.31), and overweight sufferers (BMI>30) had an elevated danger of LKC on the one-year follow-up (P=zero.03; odds ratio [OR]=three.2).
DISCUSSION: Evaluation of the radiological information at one-year follow-up confirmed that each one the evaluated parameters have been related to a gentle lack of correction, with no affect on the medical outcomes or implant failure. These findings verify the traits reported within the literature. The correlation between LKC and medical options, comparable to BMI, age, intercourse, smoking behavior and preoperative neurological standing was investigated. Apparently, a constructive correlation was noticed between BMI and LKC, and overweight sufferers with BMI>30 had an elevated danger of LKC at one-year follow-up (OR three.2); to our data this discovering has by no means earlier than been reported.
CONCLUSION: Quick-segment fixation with intermediate screws is a viable approach with constructive medical and radiological outcomes at one-year follow-up. Nevertheless, surgeons must be conscious that in overweight sufferers (BMI>30) this system is related to an elevated danger of LKC.
LEVEL OF EVIDENCE: three.
PMID: 27496720 [PubMed – indexed for MEDLINE]