ABSTRACT

Purpose:

The aim of this study is to demonstrate the relationship between the communition of vertebral fracture and severity of kyphotic deformity, pain, functional and clinical status in patients who had posttraumatic kyphotic deformity.

Method:

In this study, 44 patients who had posttraumatic kyphosis after anterior vertebrectomy, anterior strut grafting and anterior instrumentation and had available conventional radiographies and computerized tomography scans were evaluated retrospectively. The load sharing classification (PS) that described by McCormack Karaikovic and Gaines were calculated in all patients. The patients who had kyphotic deformity bigger than 30 degrees and undergone surgical treatment were included in the study. Mean age was 40.4 ± 16.8 (21-66) and there were 26 (59.1 %) male and 18 (40.9 %) female patients. Local kyphosis angles were measured with Cobb's method in lateral radiographies preoperatively and then adjusted as "Sagittal Index" (SI) according to the fracture location. The pain and functional capacitys scores were calculated with "Pain and Functional Evaluation" (PFA) scale. The clinical status scores were calculated with SRS-22 questionarie, with pain, function, mental status, apperience and satisfaction scored each questions with 5 points and total score between 0 and 5. The relationship between PS and SI scores and PFA and SRS-22 scores were statistically evaluated.

Findings:

Mean preoperative SI value was 49.7° ± 14.7° (30°- 80°). When allpatients were evaluated PS score was 7.9 ± 1.1 and statistically significant positive correlation was found between PS and SI values (r: 0.799, p < 0.01). Preoperative average PFA score was 16.3 ± 2.4 when all patients were included. Preoperative SRS-22 scores were calculated as 2.9 ± 1.1, 3.4 ± 0.9, 3.3 ± 0.9, 3.1 ± 0.9, and 2.8 ± 1.0 in pain, function, mental status, apperience and satisfaction questions respectively, and statistically significant positive correlation was found between PFA and SRS-22 scores. It was determined that PS scores had statistically significant positive relationship with PFA scores (r: 0.899, p < 0.01) and negative relationship with total SRS-22 scores (r: -0.885, p < 0.01)

Conclusion:

According to the datas of this study, it was concluded that the communition scores in thoracolumbar vetrebral fractures had correlation with severity of posttraumatic kyphotic deformity, pain, functional capacity and clinical status in neglected fractures, and this score was thought as a good guide when deciding the treatment for prevention of posttraumatic kyphotic deformity that is possibly cause of pain and bad satisfaction of the patient.