Loss of Correction in Thoracolumbar Junction Fractures with Posterior Fusion

Abstract

Objective: A retrospective study evaluated clinical and
radiological results of the patiens with thoracolumbar
junction fractures who were operated with posterior
instrumentation.
Method: In this study, the loss of correction in 20
consecutive patients who underwent posterolateral
spinal fusion with Alici instrumentation for unstable
thoracolumbar junction fractures was investigated.
According to the outcome of  the operations, patients
were divided into two groups. The first group
comprised those patients (12 patients= 60 %) in whom
screws were successfully and correctly inserted and
the second included the ones (8 patients, 40 %) with
incorrectly inserted screws.
Radiological evaluation was done by measuring
anterior height loss (AHL), kyphotic angle (KA) and
sagittal index (SI) from conventional lateral
radiography, also spinal canal occupation (SCO) from
computerized tomography scans pre and
postoperatively.
Results: There was statistically significant difference
between postoperative AHL values of group 1 and
group 2 (early postoperative value p<0.05, late
postoperative value p<0.01) and also between early and
late postoperative values in both groups (p<0.0001).
Although there was no  difference between two groups’
early postoperative KA and SI values (p>0.05) late
postoperative values (p<0.05) were different. On the
other hand  no statistically significant difference was
demonstrated between two groups’ postoperative SCO
values (p>0.05).
All the patients except three, returned to their jobs
following the operation. We have observed solid fusion
both clinically and radiologically in all patients. Two
patients have developed complications, one had a
cerebrospinal fluid fistula, which later resolved
spontanously and the other had serious infection and
which required removal of the instrumentation.
Conclusion: Posterolateral fusion is recommended to
provide original sagittal contour. In long term,
functional recovery of patients may favour the surgical
option for the  treatment of these fractures, despite
significant statistical difference between two groups
in respect of loss of correction.
Key words: Thoracolumbar junction fracture, Correction
loss

Keywords

• -