Survival Analysis of Posterior Short Fusion in Thoracolumbar Fracture: Significance of Load-Sharing Score and Bone Mineral Density-Changseop.
10.4184/jkss.2001.8.2.113
- Author:
Changseop LEE
1
;
Jang Seok CHOI
;
Young Chang KIM
;
Seong Suk SEO
;
Ki Chan AHN
;
Jin Wook JEON
;
Jae Hoon SHIN
;
Chae Oh NA
Author Information
1. Department of Orthopedics, Paik Hospital, Inje University, Pusan, Korea. osman64@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Thoracolumbar fracture;
Posterior short fusion;
Survival rate;
Prognostic factors
- MeSH:
Bone Diseases, Metabolic;
Follow-Up Studies;
Humans;
Multivariate Analysis;
Retrospective Studies;
Survival Analysis*;
Survival Rate
- From:Journal of Korean Society of Spine Surgery
2001;8(2):113-120
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the fixation survival rate and the radiologic prognostic factors of posterior short fusion in thoracolumbar fracture. SUMMARY OF BACKGROUND DATA: Posterior short fusion has the advantage of saving motion segments in spite of high fixation failure rate. The high load-sharing score is well known as a cause of fixation failure, but the effect of osteopenia is not evaluated. MATERIALS AND METHODS: Authors evaluated 27 patients treated surgically with posterior short fusion using pedicle screws as thoracolumbar fractures from 1995 to 1999. The median follow-up was 20.5 months (6-54). The survivorship using Kaplan-Meier method and the radiologic prognostic factors were evaluated. RESULTS: The sagittal index was preoperatively 16.7 dgree (+/-7.9 SD), immediate postoperatively 6.9 dgree (+/-4.6), and at last follow-up 10.6 dgree (+/-6.9). The fixation failures were detected in 4 patients, and the failure time was ranged from 6 months to 11(median 7.5). The overall survival rate was 82.3% at the last follow-up. The significant prognostic variables were load-sharing score, Jikei grade, compression percent and age in uni-variate analysis, but the load-sharing score and Jikei grade were significant prog-nostic factors in multivariate analysis. CONCLUSIONS: In decision to perform posterior short fusion, the load-sharing score and evidence of osteopenia should be consid-ered as a prognostic factors to avoid fixation failure in thoracolumbar fracture.
