ABSTRACT

Objective:

To evaluate the relation between the radiological parameters and the clinical outcome in surgically treated thoracolumbar burst fractures.

Material and methods:

The radiological parameters and the clinical results obtained in the pre-operative, the post-operative periods and during the last control visits were evaluated in 17 patients who underwent posterior segmental transpedicular instrumentation and posterolateral fusion due to single level thoracolumbar vertebra fracture without neurological deficit. The radiological parameters that were evaluated included anterior body height loss (ABHL), local kyphosis angle (LKA) and the sagittal index (SI). Also the transverse and the anterior-posterior spinal canal diameters were compared in 9 of the the 17 patients. The clinical results were evaluated using Visual Analogue Scala (VAS) and Oswestry scoring system. The relation between the radiological results and the clinical results were evaluated.

Results:

The mean follow-up period was 26 months (range 13-51 months). Although it was observed that there had been a significant correction in ABHL in the post operative evaluation when compared with the pre-operative values, there was a significant loss in vertebral body height during the long term follow-up. LKA also had a corruption in the long term follow-up, even it went negative as the lordosis of the spinal column was achieved in the post operative period. SI was decreased in the early pot operative period, but also there was a loss of correction in this parameter. In all of the 9 patients in whom computerized tomography was obtained, it had been observed that spinal canal diameters were significantly increased. Mean VAS score was 2.12 ± 1.7 and the mean Oswestry score was 9.24 ± 6.4 during the last control visits. According to the statistical evaluation using Canonical group analysis, ABHL was not correlated with VAS scores (r<0.3) and Oswestry scores (r<0.3). However we found out that LKA (r>0.5) and SI (r>0.5) were significantly in correlation with clinical scores.

Conclusion:

The correction of the sagittal plane alignment is one of the important factors which influence on the success of the surgical procedures in the treatment of thoracolumbar fractures.