Long term radiological outcomes of unstable thoraco-lumbar fractures without neurological deficit

Abstract

ObjectiveTo analyse the radiological outcomes in the long term of unstable thoraco-lumbar fractures. Material and methodsRetrospective review of 100 patients with unstable thoracolumbar fractures treated with posterolateral fusion and short screw fixation for compression and flexion-distraction type fractures, and long segment posterior fixation for fractures-dislocations or more than one vertebra fractured, between 2000 and 2010 at three different hospital centres. Six radiological parameters were measured annually during a 4-year period: Fracture angle, kyphotic deformity, sagittal index, percentage of compression, degree of displacement and deformation angle. ResultsA total of 100 patients were included with a median age of 36.4 years and a median follow-up period of 7.2 years. Fracture angle rose from 11.6° to 14.5° (increase of 25%), kyphotic deformity from 14.5° to 16.7° (increase of 15.17%), sagittal index from 8.7 to 10.8 (increase of 24.13%), percentage of compression from 31.8% to 36.5% (increase of 6.88%), degree of displacement from 2.8mm to 4.6mm (increase of 14.77%) and deformation angle from 19.7° to 21.4° (increase of 8.62%). DiscussionAll the radiological parameters studied lost correction throughout the 48 months of follow-up, being the fracture angle the most affected one. Nevertheless, the greatest loss of correction occurs in the first postoperative year, stabilising the parameters afterwards over the 4 years of follow up. We routinely recommend the measurement of all previous parameters for the follow up of unstable thoracolumbar fractures.