Do spinopelvic parameters affect the severity of thoracolumbar trauma differently between in-vehicle traffic accidents and falling from a height?

Abstract

Objective: Although there is a comprehensive characterization of the impact of spinopelvic parameters on outcomes after degenerative spine surgery, the impact of spinopelvic parameters on thoracolumbar trauma has not yet been defined. In the present study, it was aimed to reveal the correlation between the severity of vertebral fractures developing after trauma according to the mechanism of occurrence and sagittal spinopelvic parameters. Materials and methods: Patients with thoracolumbar vertebra fractures were evaluated retrospectively. The patients were divided into two groups: in-vehicle traffic accident (sitting group) and fall from height (standing group). The pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and vertebral Hounsfield unit (HU) values were measured on computed tomography (CT) scans. Results: The results of the multivariate logistic regression analysis performed in the study revealed that a one-unit increase in PI reduced the risk of more comminuted fractures (A2 and above) by 0.90 times in sitting position trauma (Hazard ratio (HR): 0.90; 95% CI: 0.84–0.96; p=0.002) and by 0.96 times in standing position trauma (HR: 0.96; 95% CI: 0.93–0.99; p=0.040). Conclusions: It was observed that in vertebral fractures developed after trauma, the fact that the vertebral column of patients with low PI is more rigid increased the severity of the fracture.