Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level

Jung Hoon Kim; Sung Soo Kim; Jin Ho Cho; Bo Hoon Jang; Jin Hwan Kim

doi:10.12671/jkfs.2013.26.1.21

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Kim, Kim, Cho, Jang, and Kim: Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2013; 26(1): 21-26.

Published online: 17 January 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.1.21

Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level

Jung Hoon Kim, M.D., Sung Soo Kim, M.D.^*, Jin Ho Cho, M.D., Bo Hoon Jang, M.D., Jin Hwan Kim, M.D.

Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

^*Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.

Address reprint requests to: Jin Hwan Kim, M.D. Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, 170, Juhwa-ro, Ilsanseo-gu, Goyang 411-706, Korea. Tel: 82-31-910-7968, Fax: 82-31-910-7967, jhkim@paik.ac.kr

Received 16 June 2012 Revised 23 July 2012 Accepted 26 October 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study is to decide the optimal level of fusion with comparing the results between the short segment fusion and long segment fusion treated with pedicle screw instrumentation, including fractured vertebra in thoracolumbar junctional fractures.

Materials and Methods

From February 2000 to November 2009, fifty three patients with junctional fracture of thoracolumbar spine were treated with pedicle screws and posterior fusion at our hospital. They were divided into two groups, the short segment group and long segment group. Preoperatively, immediate postoperative and last follow-up lateral radiological evaluation was done by measuring the correction and loss of segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle. In addition, operation time and amount of intraoperative bleeding were measured.

Results

There were no significant differences of statistical analysis regarding the radiological variables between the two groups, especially the loss of corrected segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle (p>0.05). However, operative time in the short segment group (234 minutes) was shorter than the long segment group (284 minutes), and there was statistical significance (p=0.002).

Conclusion

We recommend the short segment transpediculr instrumentation one level above and one level below, including the fractured vertebra for thoracolumbar junctional fracture with 6 points or less of the load-sharing score.

Keywords: Thoracolumbar spine, Spine fracture, Posterior fixation, Fusion level

Figures and Tables

Fig. 1

Radiologic parameters.

(A) Kyphotic angle (°).

(B) Wedge angle (°).

(C) Compression rate (%).

(D) Instrumented vertebra angle (°).

Table 1

Causes of Injury

Values are presented as number or number (%).

Table 2

Injured Levels of Fractured Vertebra

Values are presented as number or number (%).

Table 3

Patient Characteristics, Preoperative Variables

Table 4

Immediate and Last Postoperative Variables

Table 5

Correction of Postoperative Variables

Table 6

Loss of Postoperative Variables

Table 7

Loss of Postoperative Variables

^*Significant differences (p-value<0.05).

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