Junxin Zhang1,2, Hao Liu1,2, Hui Liu3, Angela Carley Chen4, Fan He1,2, Feng Zhou1,2, Huilin Yang1,2, Tao Liu5,6. 1. Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188, Shizi Street, Suzhou, 215006, Jiangsu, China. 2. Orthopaedic Institute, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. 3. Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. 4. Health Study, University of Waterloo, Waterloo, Canada. 5. Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188, Shizi Street, Suzhou, 215006, Jiangsu, China. liutao8250@suda.edu.cn. 6. Orthopaedic Institute, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. liutao8250@suda.edu.cn.
Abstract
PURPOSE: To compare intermediate screws (IS) with kyphoplasty (KP) in posterior short-segment fixation (PSSF) for patients with single-level thoracolumbar burst fractures. METHODS: Between 2010 and 2016, 1465 patients were retrospectively reviewed; 48 patients were enrolled with a minimal follow-up of 2 years. Perioperative and functional outcomes were compared. The regional Cobb angle (CA) was included in radiographic analysis. Implant failures or CA correction loss over 10° were regarded as surgical failures. Multiple linear regression was performed to investigate the risk factors of kyphosis recurrence. RESULTS: Fluoroscopic time (23.7 ± 3.6 vs. 79.3 ± 12.1 s, p < 0.001), operative time (109.6 ± 13.1 vs. 123.8 ± 19.0 min, p = 0.006) and blood loss (104.6 ± 34.9 vs. 129.1 ± 21.7 ml, p = 0.005) were all lower in the IS group. The KP group had lower Visual Analogue Scale scores (3.3 ± 0.9 vs. 2.7 ± 0.8, p = 0.028) and greater anterior body height (ABH) (30.3 ± 9.0 vs. 36.3 ± 11.0%, p = 0.044) after surgery, and less correction loss (5.6 ± 2.7 vs. 0.4 ± 1.2%, p < 0.001). Both groups had a CA correction loss of 4° with a 10% failure rate. The A3 Magerl subclassification, smaller preoperative ABH and smaller postoperative CA had positive correlations with CA correction loss. CONCLUSION: PSSF with KP provides better back pain relief, greater ABH reduction and less correction loss, while IS has the advantages of less operative time, fluoroscopic time and blood loss. Magerl subclassification of burst fracture is a potential predictor for recurrent kyphosis. Reducing fractured vertebral body height rather than segmental curvature may be more important in PSSF. STUDY DESIGN: Retrospective, non-randomized controlled study. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: To compare intermediate screws (IS) with kyphoplasty (KP) in posterior short-segment fixation (PSSF) for patients with single-level thoracolumbar burst fractures. METHODS: Between 2010 and 2016, 1465 patients were retrospectively reviewed; 48 patients were enrolled with a minimal follow-up of 2 years. Perioperative and functional outcomes were compared. The regional Cobb angle (CA) was included in radiographic analysis. Implant failures or CA correction loss over 10° were regarded as surgical failures. Multiple linear regression was performed to investigate the risk factors of kyphosis recurrence. RESULTS: Fluoroscopic time (23.7 ± 3.6 vs. 79.3 ± 12.1 s, p < 0.001), operative time (109.6 ± 13.1 vs. 123.8 ± 19.0 min, p = 0.006) and blood loss (104.6 ± 34.9 vs. 129.1 ± 21.7 ml, p = 0.005) were all lower in the IS group. The KP group had lower Visual Analogue Scale scores (3.3 ± 0.9 vs. 2.7 ± 0.8, p = 0.028) and greater anterior body height (ABH) (30.3 ± 9.0 vs. 36.3 ± 11.0%, p = 0.044) after surgery, and less correction loss (5.6 ± 2.7 vs. 0.4 ± 1.2%, p < 0.001). Both groups had a CA correction loss of 4° with a 10% failure rate. The A3 Magerl subclassification, smaller preoperative ABH and smaller postoperative CA had positive correlations with CA correction loss. CONCLUSION: PSSF with KP provides better back pain relief, greater ABH reduction and less correction loss, while IS has the advantages of less operative time, fluoroscopic time and blood loss. Magerl subclassification of burst fracture is a potential predictor for recurrent kyphosis. Reducing fractured vertebral body height rather than segmental curvature may be more important in PSSF. STUDY DESIGN: Retrospective, non-randomized controlled study. These slides can be retrieved under Electronic Supplementary Material.
Authors: Alexander R Vaccaro; Ronald A Lehman; R John Hurlbert; Paul A Anderson; Mitchel Harris; Rune Hedlund; James Harrop; Marcel Dvorak; Kirkham Wood; Michael G Fehlings; Charles Fisher; Steven C Zeiller; D Greg Anderson; Christopher M Bono; Gordon H Stock; Andrew K Brown; Timothy Kuklo; F C Oner Journal: Spine (Phila Pa 1976) Date: 2005-10-15 Impact factor: 3.468
Authors: J J Verlaan; C H Diekerhof; E Buskens; I van der Tweel; A J Verbout; W J A Dhert; F C Oner Journal: Spine (Phila Pa 1976) Date: 2004-04-01 Impact factor: 3.468