Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors have no conflicts of interest directly relevant to the content of this article. 11. Spine J. 2015 Aug 1;15(8):1796-803. doi: 10.1016/j.spinee.2014.03.012. Epub 2014 Mar 15. Viability and long-term survival of short-segment posterior fixation in thoracolumbar burst fractures. Pellisé F(1), Barastegui D(2), Hernandez-Fernandez A(3), Barrera-Ochoa S(4), Bagó J(5), Issa-Benítez D(6), Cáceres E(5), Villanueva C(7). Author information: (1)Spine Unit, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. Electronic address: 24361fpu@comb.cat. (2)Orthopaedics, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. (3)Spine Unit, Hospital Universitario Donostia, San Sebastián, Calle Doctor Begiristain, 117, 20080 San Sebastián, Guipúzcoa Spain. (4)Hand and Upper Extremity Unit, ICATME - Institut Universitari Quirón-Dexeus, Carrer de Sabino Arana, 5, 08028 Barcelona, Spain. (5)Spine Unit, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. (6)Spine Research, Vall d'Hebron Institut de Recerca, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. (7)Clinica del Pilar, Carrer de Balmes, 271, 08006 Barcelona, Spain. BACKGROUND CONTEXT: Short-segment pedicle screw instrumentation constructs for the treatment of thoracolumbar fractures gained popularity in the 1980s. The load-sharing classification (LSC) is a straightforward way to describe the extent of bony comminution, amount of fracture displacement, and amount of correction of kyphotic deformity in a spinal fracture. There are no studies evaluating the relevance of fracture comminution/traumatic kyphosis on the long-term radiologic outcome of burst fractures treated by short-segment instrumentation with screw insertion in the fractured level. PURPOSE: To evaluate the efficacy of the six-screw construct in the treatment of thoracolumbar junction burst fractures and the influence of the LSC score on the 2-year radiologic outcome. STUDY DESIGN: Case series of consecutive patients of a single university hospital. PATIENT SAMPLE: Consecutive patients from one university hospital with nonosteoporotic thoracolumbar burst fractures. OUTCOME MEASURES: Being a radiology-based study, the outcome measures are radiologic parameters (regional kyphosis [RK], local kyphosis, and thoracolumbar kyphosis [TLK]) that evaluate the degree and loss of correction. METHODS: Retrospective analysis of all consecutive patients with nonosteoporotic thoracolumbar burst fractures managed with a six-screw construct in a single university hospital, with more than 2 years' postoperative follow-up. RESULTS: Eighty-six patients met the inclusion criteria, and 72 (83.7%) with available data were ultimately included in the study. The sample included 53 men and 19 women, with a mean (standard deviation [SD]) age of 35.6 years (14.4 years) at the time of surgery. Mean LSC score was 6.3 (SD 1.6, range 3-9). Forty-four of 62 (70.9) fractures had a score greater than 6. Mean (SD) RK and TLK deteriorated significantly during the first 6 months of follow-up: 2.90° (4.54°) p=.005 and 2.78° (6.45°) p=.069, respectively. Surgical correction correlated significantly (r=0.521, p