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THORACOLOMBAR BURST FRACTURES: SHORT FIXATION, WITHOUT ARTHRODESIS AND WITHOUT REMOVAL OF THE IMPLANT

FRATURA TORACOLOMBAR EXPLOSÃO: FIXAÇÃO CURTA, SEM ARTRODESE E SEM A RETIRADA DO IMPLANTE

ABSTRACT

Objectives:

To present the functional outcomes, through the first case series in our country, of patients with thoracolumbar burst fractures (A3,A4), submitted to short posterior fixation, without arthrodesis and without removal of the implants, until the end of the minimum follow-up of one year.

Methods:

Fifty five patients consecutively treated between January/2010 and January/2019 were evaluated through medical records and imaging exams. Radiographic analysis was performed by mea suring local and segmental kyphosis using the Cobb method. Functional assessment was analyzed using the non-specific SF-36 questionnaire and the 1983 Denis pain and work-specific questionnaire, applied after 12 months of follow-up.

Results:

With a loss of five patients (9%), 22 (44%) patients reported having minimal and occasional pain and 8 (16%) patients reported having no pain. Three (6%) patients responded that they were completely incapacitated. Patients had a mean score of 73.16 points in the SF-36 domains. There was a significant reduction in kyphosis in 12 months (9.1±5.2 [min-max 0-22]) compared to the preoperative period (14.9±7.8 [min-max 0-32]) ( p≤0.01). One patient required implant removal due to the symptomatic prominence of the implant.

Conclusion:

This case series suggests that the technique leads to satisfactory functional results, without implant failure or significant kyphosis after a minimum follow-up of 12 months of treatment. Evidence Level IV; Case series.

Keywords:
Accidents; Thoracic Vertebrae; Lumbar Vertebrae; Arthrodesis

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