Abstract

Serdar Sargın, Bekir Yavuz Uçar*, Serdar Necmio lu, Mehmet Bulut and Mehmet Gem

A retrospective study of clinical and radiological results of nonfusion operative treatment for thoracolumbar fractures. In this study, we aimed to demonstrate that fusion was not always required in the surgical treatment with posterior instrumentation for thoracolumbar vertebral fractures and to show the success of surgical treatment without fusion. Fusion was added considering failure of the implant and inability to maintain the corrected kyposis angle after posterior instrumentation for thoracolumbar vertebral fractures. Fusion related problems such as the fusion-induced loss of stability in posterior elements, graft donor site problems, increased blood loss, allograft associated infections, and prolonged operation time, focus attention on surgical treatment without fusion. We intended to demonstrate the alignment and stability of the spine in the coronal and sagittal planes after treatment without fusion. Kyphosis angle and the extent of the collapse were measured in preoperative, postoperative and final examination films of 60 patients with thoracolumbar vertebral fractures. Based on the computerized tomography and magnetic resonance images of the patients, we evaluated intracanal fragments, the presence of pedicle and laminar fractures, posterior ligamentous complex status and the presence of medullary edema. With an aim to evaluate pain and quality of life of the patients, the oswestry disability ındex (ODI) and Roland morris disability questionnairre were tested. The obtained results were evaluated and the final postoperative conditions of the patients were investigated. For the statistical analysis of local kyphosis angle, sagittal index and percentage of anterior collapse that were measured in preoperative, postoperative and final examinations of the patients, descriptive analysis and one way analysis of variance for related samples were conducted. And Pearson’s correlation test was used for the analysis of the relationship between radiological measurements and clinical functions. It can be concluded that the patients derived radiological and statistically significant benefit from the surgery in terms of restoration of anterior column height and that postoperative radiological values were maintained with minimal reduction until the final examination (p>0.05) and that the surgery was effective in remodeling of the vertebral body. When evaluated in terms of the clinical results, a negative relationship (r = 0.300) between Oswestry scores and percentage of anterior collapse was found to be statistically significant (p0.05) until the final examination, support our conclusion that fusion is not required. Hence, we can eliminate complications of fusion surgery.