Loss of Correction in Thoracolumbar Junction Fractures with Posterior Fusion

Abstract

Objective: A retrospective study evaluated clinical andradiological results of the patiens with thoracolumbarjunction fractures who were operated with posteriorinstrumentation.Method: In this study, the loss of correction in 20consecutive patients who underwent posterolateralspinal fusion with Alici instrumentation for unstablethoracolumbar junction fractures was investigated.According to the outcome of the operations, patientswere divided into two groups. The first groupcomprised those patients (12 patients= 60 %) in whomscrews were successfully and correctly inserted andthe second included the ones (8 patients, 40 %) withincorrectly inserted screws.Radiological evaluation was done by measuringanterior height loss (AHL), kyphotic angle (KA) andsagittal index (SI) from conventional lateralradiography, also spinal canal occupation (SCO) fromcomputerized tomography scans pre andpostoperatively.Results: There was statistically significant differencebetween postoperative AHL values of group 1 andgroup 2 (early postoperative value p<0.05, latepostoperative value p<0.01) and also between early andlate postoperative values in both groups (p<0.0001).Although there was no difference between two groups’early postoperative KA and SI values (p>0.05) latepostoperative values (p<0.05) were different. On theother hand no statistically significant difference wasdemonstrated between two groups’ postoperative SCOvalues (p>0.05).All the patients except three, returned to their jobsfollowing the operation. We have observed solid fusionboth clinically and radiologically in all patients. Twopatients have developed complications, one had acerebrospinal fluid fistula, which later resolvedspontanously and the other had serious infection andwhich required removal of the instrumentation.Conclusion: Posterolateral fusion is recommended toprovide original sagittal contour. In long term,functional recovery of patients may favour the surgicaloption for the treatment of these fractures, despitesignificant statistical difference between two groupsin respect of loss of correction.Key words: Thoracolumbar junction fracture, Correctionloss