L Proietti1, L Scaramuzzo2, G R Schirò3, S Sessa4, F C Tamburrelli5, G Cerulli6. 1. Department of Orthopaedic Science and Traumatology Spine Surgery Division, Catholic University, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: proiettil@yahoo.it. 2. Spine Surgery Division 1, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy. Electronic address: scaramuzzolaura@gmail.com. 3. Department of Orthopaedic Science and Traumatology Spine Surgery Division, Catholic University, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: giusepper.schiro@gmail.com. 4. Department of Orthopaedic Science and Traumatology Spine Surgery Division, Catholic University, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: sergiosessa84@yahoo.it. 5. Department of Orthopaedic Science and Traumatology Spine Surgery Division, Catholic University, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: f.tamburrelli@tiscali.it. 6. Department of Orthopaedic Science and Traumatology Spine Surgery Division, Catholic University, Largo A. Gemelli 1, 00168 Roma, Italy. Electronic address: g_cerulli@tin.it.
Abstract
BACKGROUND: Aim of the study was to evaluate degenerative lumbar facet-joints changes after percutaneous pedicle screw fixation (PPSF) in the treatment of lumbar fractures. MATERIALS AND METHODS: Thirty patients underwent short PPSF without fusion. CT-scan was performed in the pre- and post-operative time at four, eight and 12 months. The six zygapophyseal joints adjacent the fracture's level were evaluated. RESULTS: At four months patients showed no differences between pre- and post-operative joint radiographic aspect. At eight and 12 months, CT-scan demonstrated a progressive degeneration only in the middle joints respectively in 21.42% and in 76.92% of the cases. All 10 disrupted facet joints showed progressive degenerative changes at eight and 12 months. CONCLUSION: Lumbar percutaneous fixation without fusion induces little degenerations essentially collocated in the middle joints close to fracture level at eight and 12 months. In the proximal and distal joints adjacent the screws degenerative changes can be seen only when associated to pedicle-screw encroachment.
BACKGROUND: Aim of the study was to evaluate degenerative lumbar facet-joints changes after percutaneous pedicle screw fixation (PPSF) in the treatment of lumbar fractures. MATERIALS AND METHODS: Thirty patients underwent short PPSF without fusion. CT-scan was performed in the pre- and post-operative time at four, eight and 12 months. The six zygapophyseal joints adjacent the fracture's level were evaluated. RESULTS: At four months patients showed no differences between pre- and post-operative joint radiographic aspect. At eight and 12 months, CT-scan demonstrated a progressive degeneration only in the middle joints respectively in 21.42% and in 76.92% of the cases. All 10 disrupted facet joints showed progressive degenerative changes at eight and 12 months. CONCLUSION: Lumbar percutaneous fixation without fusion induces little degenerations essentially collocated in the middle joints close to fracture level at eight and 12 months. In the proximal and distal joints adjacent the screws degenerative changes can be seen only when associated to pedicle-screw encroachment.