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KMID : 1148120150050020050
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Journal of Advanced Spine Surgery
2015 Volume.5 No. 2 p.50 ~ p.54
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Factors for Early Pull-Out of Pedicle Screws after Posterior Pedicle Screw Fixation for Thorcolumbar Burst Fractures
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Hong Chang-Hwa
Shin Byung-Joon
Lee Jae-Chul
Kim Dong-Soo
Kim Sang-Bum
Min Sang-Hyuk
Cho Tae-Yoon
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Abstract
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Study Design: Retrospective study.
Purpose: Pull-out of pedicle screw in posterior pedicle fixation for thoracic and lumbar burst fractures causes delayed rehabilitation, persistant pain, and imblance of sagittal plane. In this study we try to analyse the factors that cause the pull-out of pedicle screw.
Materials and Methods: From March 01, 2006 to December 31, 2009, we assorted into two group; Group I for pullout pedicle, Group II for control. Plane lateral x-ray view film of thoracolumbar spine was taken on preoperation, postoperation, the first time when screw was pulled out and last follow up. we measure inserted angle for the upper endplate of screw, convergency angle and change of body height loss and kyphotic angle. We analysed corelation between these measuring values and pedicle screw pull-out by Mann-Whitney test and T-test.
Results: Pull-out of pedicle screw was found at mean 5weeks among nine cases. For inserted pedicle screws, which place in upper and lower vertebral body of fractured one, Value of inserted angle for upper end plate and convergency angle was found non-significant(p>0.05, Mann-Whitney test). Restoration of height loss and kyphotic angle of fractured vertebral body was statically significant(p<0.05, T-test).
Conclusion: In posterior pedicle fixation for thoracic and lumbar burst fractures, sufficient restoration of height loss and kyphotic angle is important factor for prevention of screw pull-out than inserted angle for upper end plate and convergency angle at a short period of time. Therefore we think that sufficient anterior fixation of vertebral body and restoration of kyphotic angle have a decisive effect on prognosis of patients.
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KEYWORD
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Thoracolumbar spine, Burst fracture, Posterior pedicle screw fixation, Pull-out
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