Introduction
Materials and methods
Patients
Data collection and clinical follow-up
Indication for anterior stabilization and surgical technique
Statistics
Results
Demographics
n
| 46 |
Sex M:F | 26:20 (56:44%) |
Transfer from other hospital | 22 (48%) |
Known psychiatric history | 6 (13%) |
Mechanism of injury | |
Fall/jump off height | 18 (39%) |
Traffic accident | 15 (33%) |
Fall from stairs | 5 (11%) |
Sports accident | 3 (7%) |
Fall off horse | 2 (4%) |
Object on back/entrapment | 2 (4%) |
Conventional fall | 1 (2%) |
ISS (median, IQR) | 9 (9–13) |
Load sharing classificationa | |
4–6 | 16 (35%) |
7–9 | 30 (65%) |
Level of injury | |
Th6–Th9 | 8 (17%) |
Th11–L1 | 34 (74%) |
L2 | 4 (9%) |
AO morphologyb | |
A2 | 1 (2%) |
A3 | 14 (31%) |
A4 | 31 (67%) |
B2 | 18 (39%) |
C | 1 (2%) |
Patients with multiple vertebral fractures (type—A/B/C) | 18 (39%) |
Posterior segments immobilizedc | |
2 | 36 (82%) |
3 | 6 (13%) |
4 | 2 (5%) |
Anterior segments immobilizedc | |
1 | 18 (39%) |
2 | 27 (59%) |
3 | 1 (2%) |
Removal of posterior implant | |
Yes | 23 (52%) |
No | 21 (48%) |
Quality of life
SF36 domain | ISS < 16 (n = 38) | ISS ≥ 16 (n = 8) |
---|---|---|
Physical function | 77 ± 17 | 63 ± 39 |
Role physical | 63 ± 39 | 41 ± 42 |
Bodily pain | 63 ± 23 | 63 ± 27 |
General health | 69 ± 22 | 59 ± 24 |
Vitality | 60 ± 21 | 62 ± 24 |
Social functioning | 73 ± 28 | 66 ± 29 |
Role emotional | 71 ± 40 | 67 ± 47 |
Mental health | 71 ± 22 | 82 ± 12 |
Physical component score | 47 ± 9 | 40 ± 14 |
Mental component score | 46 ± 13 | 49 ± 7 |
EQ5D | ||
EQ5D-VAS | 75 ± 15 | 75 ± 18 |
EQ5D-index | 0.81 ± 0.13 | 0.75 ± 0.23 |
N
| 31 |
Sex (M:F) | 20:11 (65:35%) |
Age (mean, SD) | 41 ± 15 |
ISS (median, IQR) | 9.0 (4–16) |
AO morphologya | |
A1 | 2 (7%) |
A2 | 1 (3%) |
A3 | 22 (71%) |
A4 | 6 (19%) |
B1–3 | 13 (42%) |
C | 3 (10%) |
Fracture level | |
T5–T8 | 4 (13%) |
T11–L1 | 20 (65%) |
L2–L4 | 7 (23%) |
Multiple fractures | |
Yes | 12 (61%) |
No | 19 (39%) |
Dorsal segments fixated | |
1 | 1 (3%) |
2 | 24 (77%) |
3 | 2 (7%) |
4–6 | 4 (14%) |
Complications | 0 |
SF36 PCS |
p
| SF36 MCS |
p
| EQ5D index | P | EQ5D VAS |
p
| |
---|---|---|---|---|---|---|---|---|
CA injury | B: − 0.063a | 0.75 | B: − 0.074a | 0.76 | B: 0.00047a | 0.88 | B: − 0.12a | 0.68 |
CA final follow-up | B: − 0.076a | 0.67 | B: − 0.024a | 0.92 | B: − 0.001a | 0.81 | B: 0.019a | 0.95 |
CA post-op to FFU | B: − 0.023a | 0.95 | B: − 0.40a | 0.40 | B: − 0.001a | 0.87 | B: − 0.29a | 0.61 |
Fracture level | ||||||||
T6–T10 | 46.86 ± 15 | 0.82° | 46.57 ± 12 | 0.96° | 0.77 ± 0.12 | 0.59° | 78.38 ± 17 | 0.55° |
T11–L2 | 45.39 ± 9 | 46.33 ± 13 | 0.80 ± 0.16 | 74.68 ± 15 | ||||
AO morphology | ||||||||
A3 | 47.15 ± 11 | 0.58° | 46.92 ± 14 | 0.95° | 0.82 ± 0.19 | 0.71° | 77.29 ± 20 | 0.58° |
A4 | 45.24 ± 10 | 46.66 ± 12 | 0.80 ± 0.14 | 74.45 ± 14 | ||||
A3 & A4 | 45.80 ± 10 | 45.28 ± 12 | 0.79 ± 0.14 | 74.85 ± 13 | ||||
B2 | 46.06 ± 11 | 0.94° | 47.53 ± 14 | 0.58° | 0.81 ± 0.18 | 0.76° | 76.56 ± 19 | 0.73° |
Ant. segments | ||||||||
1 | 48.50 ± 10 | 0.13° | 46.39 ± 12 | 0.97° | 0.83 ± 0.19 | 0.38° | 78.83 ± 11 | 0.17° |
2 | 43.63 ± 10 | 46.25 ± 13 | 0.78 ± 0.12 | 72.81 ± 18 | ||||
PIR | ||||||||
Yes | 45.91 | 0.89° | 47.45 | 0.55° | 0.83 | 0.47° | 76.00 | 0.90° |
No | 46.33 | 44.94 | 0.79 | 75.38 | ||||
Complications | ||||||||
No (n = 38) | 45.95 ± 10 | 0.57° | 45.47 ± 13 | 0.20° | 0.81 ± 0.14 | 0.44° | 75.05 ± 16 | 0.73° |
Yes (n = 5) | 43.20 ± 11 | 53.20 ± 8 | 0.75 ± 0.26 | 77.60 ± 9 |
Complications
Complications | |
---|---|
Pneumonia | 1 (2%) |
Ileus | 1 (2%) |
Spondylodiscitis (different level) | 1 (2%) |
Cage dislocation | 1 (2%) |
Persisting haemothorax (re-thoracotomy) | 1 (2%) |
Total | 5 (10%) |
Radiologic parameters
Anterolateral plating | Moment 1 | Moment 2 | Mean difference (kyphosis+, lordosis−) | (95% CI) |
---|---|---|---|---|
1 anterior segment | CA injury | CA post-op | − 6.5** | (− 9.4 to − 3.6) |
CA post OK | CA 1 year | 4.7** | (2.6 to 6.8) | |
CA post-op | CA FFU | 9.3** | (6.5 to 12.1) | |
CA injury | CA FFU | 2.2 | (− 2.1 to 6.5) | |
2 anterior segments | CA injury | CA post-op | − 8.3** | (− 11.6 to − 5.1) |
CA post OK | CA 1 year | 2.8** | (1.5 to 4.3) | |
CA post-op | CA FFU | 4.7** | (2.4 to 6.9) | |
CA injury | CA FFU | − 3.6 | (− 7.4 to 0.2) |