Analysis of Factors Affecting Postoperative Loss of Reduction in Unstable Thoracolumbar Fractures (흉-요추부 불안정성 골절 수술 후 정복 소실에 영향을 미치는 요인 분석)

SOH JAE WAN (소재완); Changhwa Hong (홍창화); 방청원; Jae Chul Lee (이재철); Byungjoon Shin (신병준)

Analysis of Factors Affecting Postoperative Loss of Reduction in Unstable Thoracolumbar Fractures

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2017, 24(3), pp.190~197
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

SOH JAE WAN ¹, Changhwa Hong ¹, 방청원 ², Jae Chul Lee ¹, Byungjoon Shin ¹

¹순천향대학교
²순천향대학교 의과대학 천안병원 정형외과학교실

Accredited

ABSTRACT

Study Design: Retrospective analysis Objectives: Loss of fracture reduction after posterior surgery to treat unstable thoracolumbar fractures can cause several complications. We analyzed the factors influencing postoperative loss of reduction. Summary of Literature Review: Controversy exists about the factors causing postoperative loss of reduction in thoracolumbar fractures during the follow-up period. Materials and Methods: We analyzed the records of 59 patients who underwent posterior surgery for thoracolumbar unstable fractures and had completed a minimum follow-up of 1 year. Postoperative loss of reduction was defined as 30% or more loss of vertebral body height or 15° or more progression of the kyphotic angle at the 1-year follow-up compared to immediately after surgery. The associations between the patients’ gender, age, level of fracture, injury of the posterior column, initial loss of fractured vertebral body height, loadsharing score, Thoraco-Lumbar Injury Classification and Severity score, number of fixed segments, type of pedicle screws, degree of postoperative reduction, degree of postoperative corrected kyphotic angle, changes in the insertion angle of the most proximal and the most distal pedicle screws, decreases in the upper and lower disc height of the fractured vertebral body, and postoperative loss of reduction were analyzed. Results: Thirteen patients (22.0%) had postoperative loss of reduction. Age at the time of the operation (p=0.034), initial loss of fractured vertebral body height (p=0.042), and changes in the insertion angles of the most distal pedicle screws (p=0.021) were significantly associated with postoperative loss of reduction. However, the other factors did not show a significant relationship. Conclusions: In patients who underwent posterior surgery for unstable thoracolumbar fractures, the frequency of loss of reduction was high in patients more than 45 years old at the time of the operation, with a 50% or more loss of the initial fractured vertebral body height, and with changes of 5° or more in the insertion angles of the most distal pedicle screws.

KEYWORDS

Key words: Thoracolumbar, Unstable fractures, Posterior surgery, Loss of fracture reduction

Citation status

* References for papers published after 2023 are currently being built.

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