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Temporary short segment fixation helped reduce fractured vertebra

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COPENHAGEN, Denmark — Results presented at the EuroSpine Annual Meeting, here, showed that fractured vertebra from T11 to L3 treated with posterior temporary, short segment surgical fixation could be successfully reduced with the reduction maintained through the 2-year follow-up. Investigators found this was the case whether or not vertebroplasty was performed.

Hiroyuki Aono, MD, PhD, who presented the findings, and colleagues, however, observed kyphotic changes which were due to loss of disc height after implant removal.

Among 58 consecutive patients diagnosed with thoracolumbar burst fractures that they studied, 25 were treated with vertebroplasty and 33 did not undergo vertebroplasty.

The investigators measured superior-inferior endplate angle and vertebral body angle preoperatively, immediately postoperatively, at about 1 year postoperatively and at the final follow-up. They used a load sharing classification to score all the cases for fracture severity.

Aono, in his presentation, said there was significantly greater operating time and blood loss for those patients who underwent vertebroplasty.

“On the other hand, there was no difference in load sharing score,” Aono, of Osaka, Japan, said. Based on the results, one screw broke 8 months after the initial operation, but all the patients obtained fracture union and required no additional surgeries. Regardless of whether vertebroplasty was performed in these patients, it was possible to reduce the vertebral body angle and maintain it postoperatively. Furthermore, correctional loss of superior-inferior endplate angle occurred after implant removal in some cases and any postoperative kyphotic changes that occurred were related to disc level rather than the fractured vertebra, Aono noted.

“We think injury of adjacent disc at onset is inevitable, so disc degeneration is unavoidable and this leads to correctional loss at disc level,” Aono said. “This might be a limitation of this surgical procedure.” – by Casey Tingle

Reference:

Aono H, et al. Paper #24. Presented at: EuroSpine Annual Meeting; Sept. 2-4, 2015; Copenhagen, Denmark.

Disclosure: Aono reports no relevant financial disclosures.