ABSTRACT

The early and long-term postoperative results in the sagittal plane for thoracolumbar (TL) vertebral fractures that received only posterior instrumentation and fusion were examined.

Between the years 1998–2004, 15 patients (11 males, 4 females) received surgery for a TL vertebral fracture. The average age was 34.6 (16–57) years. The average follow-up period was 8.43 (5– 11) years. Fixation with posterior pedicle screws and rods, fracture distraction and fusion were applied to all patients. Sagittal plane measurements of the patients were taken radiologically preoperatively (Group 1), early postoperatively (Group 2), and late postoperatively (Group 3). The local kyphosis angle (LKA), anterior compression angle (ACA), anterior (F) and posterior (E) column heights of the fractured vertebrae were measured and compared.

The average Group 1, 2 and 3 LKA measurements were 12.63°, 0.21° and 6.92°, respectively (p<0.001), and the ACA measurements were 14.13°, 5.83° and 6.25°, respectively (p<0.001). Significant differences were found between the average LKA, ACA and E/F scores of Group 1, Group 2 and Group 3 (p<0.001). While there was a significant difference between the averages of the LKA and E/F measurements of Group 2 and Group 3 (p<0.05), no statistical difference was found after comparing the average ACA angle (p=0.753). While there was no significant change in E in any group (p>0.05), the increase in F after surgery was considered significant (p<0.05), and no difference was observed between the averages of Group 2 and Group 3 (p>0.05). The VAS was 2.73 (0–5). While the neurological status showed obvious recovery in one case (from Frankel B to E), it remained the same in 14 cases. In the last follow-up, implant failure was seen at a rate of 70%. The VAS was 3.73 (0–5).

At the end of an average follow-up period of eight years for posterior TL fractures, no differences were found between the early and late period measurements of the ACA and anterior height. Although LKA showed a statistical loss, the degree of correction achieved in the late period was found to be significantly higher than in the preoperative period.