Comparison of the Outcomes between AO Type B2 Thoracolumbar Fracture with and without Disc Injury after Posterior Surgery

作者全名："Hu, Chenbo; Zhong, Weiyang; Chen, Zhiyu; Peng, Junmu; Li, Jianxiao; Tang, Ke; Quan, Zhengxue"

作者地址："[Hu, Chenbo; Zhong, Weiyang; Chen, Zhiyu; Peng, Junmu; Li, Jianxiao; Tang, Ke; Quan, Zhengxue] Chongqing Med Univ, Dept Orthopaed Surg, Affiliated Hosp 1, Chongqing 400016, Peoples R China"

通信作者："Quan, ZX (通讯作者)，Chongqing Med Univ, Dept Orthopaed Surg, Affiliated Hosp 1, Chongqing 400016, Peoples R China."

来源：ORTHOPAEDIC SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000836284400001

JCR分区：Q2

影响因子：2.1

年份：2022

卷号：14

期号：9

开始页：2119

结束页：2131

文献类型：Article

关键词：Disc injury; Flexion distraction injury; Posterior surgery; Thoracolumbar fracture

摘要："Objective The type AO B2 thoracolumbar fracture is a kind of flexion-distraction injury and the effect of disc injury on treatment results of patients with B2 fracture remains unclear. The objective of the current study was to compare and analyze the outcomes in AO Type B2 thoracolumbar fracture patients with and without disc injuries in terms of the Cobb angle of kyphosis, the incidence of complication, and the rate of implant failure. Methods This is a retrospective study. Of the 486 patients with thoracolumbar fractures who underwent posterior fixation, 38 patients with AO type B2 injuries were included. All the patients were divided into two groups according to changes in the adjoining discs. Disc injury group A included 17 patients and no disc injury group included 21 patients. Clinical and radiologic parameters were evaluated before surgery, after surgery, and at follow-up. Clinical outcomes included visual analogue scale (VAS) scores, incidence of complications, and incidence of implant failure. Radiologic assessment was accomplished with the Cobb angle (CA), local kyphosis (LK), percentage of anterior vertebral height (AVBH%), intervertebral disc height, and intervertebral disc angle. Fisher's precision probability tests were employed and chi square test were used to compare categorical variables. Paired sample t tests and independent-sample t tests were used to compare continuous data. Results Disc injury mainly involved the cranial disc (15/19, 78.9%). The mean follow-up period for the patients was 30.2 +/- 20.1 months. No neurologic deterioration was reported in the patients at the last follow-up. Radiological outcomes at the last follow-up showed significant differences in the CA (18.59 degrees +/- 13.74 degrees vs 8.16 degrees +/- 9.99 degrees, P = 0.008), LK (12.74 degrees +/- 8.00 degrees vs 6.55 degrees +/- 4.89 degrees, P = 0.006), and %AVBH (77.16% vs 90.83%, P = 0.01) between the two groups.Implant failure occurred after posterior fixation in five patients with disc injury who did not undergo interbody fusion during the initial surgery. Additionally, in the subgroup analysis, interbody fusion in the implant failure group were significantly different than in the no implant failure group (0% vs 75%, P = 0.009). Conclusions AO B2 fracture patients with disc injury have higher risk of complications, especially implant failure after posterior surgery. Interbody fusion should be considered in AO type B2 fracture patients with disc injury."

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