Impact of short segment fixation on Spinopelvic Sagittal Alignment in Thoracolumbar Fracture Cases
Background: Previous studies have reported the impact of thoracolumbar kyphosis induced by spinal burst fracture on spinopelvic sagittal alignment. But no study has analyzed the effects of short segment fixation on perioperative spinopelvic parameters in patients with spinal burst fracture. Thus, this study aimed to explore the impact of short segment fixation on spinopelvic sagittal alignment in patients with thoracolumbar fractures.Methods: Perioperative radiographs of 42 patients with
... lumbar fractures treated with short-segment fixation surgery were obtained. The pelvic and spinal parameters were measured, and the influence of fracture site on all parameters was retrospectively analyzed. A descriptive analysis characterizing these parameters and multivariate analysis was performed to investigate the influencing factors of thoracolumbar kyphosis.Results: The mean age of included cases was 47.1±9.9 years, Pelvic incidence(PI) was 44.1±4.7º. Preoperative fractured level kyphosis (FLK) and thoracolumbar kyphosis(TLK) were 10.3±9.9º and 15.6±10.4º, respectively. Operative corrected degree(OCD) of FLK and TLK were 6.8±7.9º and 7.7±8.4º, respectively. Preoperative parameters, including FLK, TLK, Pelvic tilt (PT), Sacral slope (SS), Lumbar lordosis (LL), were no different in the different fracture sites. PT-OCD is greater in L2~L5 fractures than T12~L1(t=0.82, P=0.03). FLK-OCD(B=0.36), LL-OCD(B=-0.34) and PT-OCD(B=0.22), as well as age(B=-0.23) were independent factors to influence TLK-OCD. pelvis anteversion and high FLK-OCD was associated with a more satisfactory correction of the TLK deformity. TLK-OCD was negatively influenced by age. Conclusion: Short segment fixation surgery can correct TLK caused by fractures. Satisfactory TLK-OCD is related to excellent fracture reduction, pelvis anteversion, and younger patients. With FLK fixed by operation, the pelvis rotates from rear to front, more obviously in lumbar fractures.