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KMID : 0388720090160040251
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Journal of Korean Society of Spine Surgery
2009 Volume.16 No. 4 p.251 ~ p.258
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More Than 5 Year Follow-Up of Thoracolumbar Fractures Treated By Pedicle Screw Fixation
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Shin Byung-Joon
Lee Jae-Chul
Kim Yun-Il
Lee Jae-Sang
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Abstract
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Study Design: This is a retrospective study.
Objectives: We wanted to analyze the frequency of instrument breakage and the long term reduction loss for patients who received pedicle screw fixation for thoracolumbar fractures.
Summary of Literature Review: A pedicle screw fixation system for thoracolumbar fractures has become popular since the late 1980s, but it is difficult to find articles mentioning its mid and long term results.
Materials and Methods : Twenty-seven patients those received pedicle screw fixation for thoracolumbar fractures and dislocations and who were followed up more than 5 years were included. The average follow-up period was 139.0 months. We compared the anterior column height, the kyphotic angle and the local kyphotic angle on serial radiographs, and we measured the changes of the intervertebral disc height and the changes of the angle between screws. We also investigated the breakage and loosening of instruments.
Results: The breakage of screws was observed in 11 cases (40.7%) and it had a statistical correlation with the loss of the lower intervertebral disc height and the loss of angles between the screws. During the follow-up, the kyphotic angle, the upper and lower disc height and the interscrew angle were decreased over time, whereas the anterior column height and wedge angle of the vertebra were maintained after the operation. There was no statistical correlation between the breakage of instruments and the degree of lower back pain.
Conclusions: On the mid and long-term follow-up of the patients who were treated by pedicle screws for thoracolumbar fractures, the correction of the kyphotic angle was lost over time and breakage of screws may eventually occur. The loss of the kyphotic angle was mainly due to the continuous loss of the intervertebral disc height.
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KEYWORD
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Thoracolumbar, Fracture, Pedicle screw fixation, Breakage, Loss of correction
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