Clinical Efficacy of Implant Removal after Posterior Spinal Arthrodesis with Pedicle Screw Fixation for the Thoracolumbar Burst Fractures

Abstract

Purpose: To evaluate the clinical efficacy of implant removal by analyzing the radiological changes after posterior spinal stabilization in patients with thoracolumbar burst fractures. Materials and Methods: Fifty-eight patients, who received surgical treatment after a thoracolumbar burst fracture with at least a two year follow-up, were enrolled in this study. An evaluation of the clinical results was based on the VAS score to examine degree of pain and discomfort. The evaluation of the radiological results was performed by measuring the changes in the kyphotic angle of the fractured vertebral bodies and the severity of the collapse of the anterior vertebral height taken after the injury, after fusion and after metal removal on the plain lateral radiograph. Results: The VAS score on pain and discomfort after removing the implants showed a significant decrease from 6.5 to 3.2 and from 5.6 to 2.8, respectively. Overall, the kyphotic angle after removing the implants increased by 3.7 o , whereas the anterior height of the fractured vertebral body after removing the implant decreased by 1.5% in correction. Conclusion: The removal of implants after posterior arthrodesis in thoracolumbar burst fractures can be performed effectively to relieve the pain and restore fl exibility but can result in the progression of kyphosis. However careful consideration should be made before removing an implant in cases of severe initial damage.