Thoracolumbar fractures: Factors predicting failure of percutaneous short- and long-segment posterior fixation
Introduction: Thoracolumbar (TL) transition trauma is frequent and challenging. Although short- (SSPF) and long-segment posterior fixation (LSPF) are its mainstay treatment, little is known about their failure rates and reasons behind it. Research question: understand why TL instrumentations fail an...
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Elsevier
2025-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529424014073 |
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| author | David Ferreira António Cruz Ana Vilela Joana Azevedo André Santos Moreira João Pereira Paulo Gil Ribeiro Nuno Oliveira Pedro Varanda Bruno Direito-Santos |
| author_facet | David Ferreira António Cruz Ana Vilela Joana Azevedo André Santos Moreira João Pereira Paulo Gil Ribeiro Nuno Oliveira Pedro Varanda Bruno Direito-Santos |
| author_sort | David Ferreira |
| collection | DOAJ |
| description | Introduction: Thoracolumbar (TL) transition trauma is frequent and challenging. Although short- (SSPF) and long-segment posterior fixation (LSPF) are its mainstay treatment, little is known about their failure rates and reasons behind it. Research question: understand why TL instrumentations fail and what factors influence it. Materials and methods: Retrospective, cohort, unicentric analysis on adult patients with acute TL trauma treated with percutaneous transpedicular SSPF or LSPF. Two groups were created, according to the presence of treatment failure at follow-up. We analyzed whether age ≥65 years old, fracture segment, posterior ligamentous complex (PLC) injury, load sharing classification (LSC) score >6, type of instrumentation (SSPF vs LSPF) and abnormal bone mineral density (BMD) were associated with failure. To achieve this, we evaluated radiological parameters at the preoperative, postoperative and follow-up appointments. Results: 87 patients were included: 60 (69.0%) without failure and 27 (31.0%) with. Age ≥65 years old (aOR = 3.66, p = 0.020), PLC injury (aOR = 2.94, p = 0.048) and SSPF (aOR = 6.75, p = 0.013) were statistically significant factors contributing to failure. The first two also presented shorter times to failure (35.2 vs 69.1 months, p = 0.013, and 25.2 vs 69.1 months, p = 0.037, respectively). In PLC injured patients, there was no statistically significant difference between SSPF vs LSPF. Discussion and conclusions: We conclude that age >65 years old, PLC injury and SSPF may be correlated with instrumentation failure. The first two factors were also associated with a shorter time to failure. |
| format | Article |
| id | doaj-art-543bd6c2968b4359ac147c1a3b7836f4 |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-543bd6c2968b4359ac147c1a3b7836f42024-12-22T05:30:04ZengElsevierBrain and Spine2772-52942025-01-015104151Thoracolumbar fractures: Factors predicting failure of percutaneous short- and long-segment posterior fixationDavid Ferreira0António Cruz1Ana Vilela2Joana Azevedo3André Santos Moreira4João Pereira5Paulo Gil Ribeiro6Nuno Oliveira7Pedro Varanda8Bruno Direito-Santos9Orthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, Portugal; Corresponding author.School of Medicine, University of Minho, Portugal – Universidade Do Minho, Campus de Gualtar, 4710-057, Braga, PortugalOrthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, PortugalOrthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, PortugalOrthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, PortugalOrthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, PortugalOrthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, PortugalOrthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, PortugalOrthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, Portugal; Life and Health Science Research Institute, University of Minho, Portugal – Universidade Do Minho, Campus de Gualtar, 4710-057, Braga, PortugalOrthopedic Surgery Department, Unidade Local de Saúde de Braga, Portugal – Sete Fontes, São Victor, 4710-243, Braga, Portugal; Life and Health Science Research Institute, University of Minho, Portugal – Universidade Do Minho, Campus de Gualtar, 4710-057, Braga, PortugalIntroduction: Thoracolumbar (TL) transition trauma is frequent and challenging. Although short- (SSPF) and long-segment posterior fixation (LSPF) are its mainstay treatment, little is known about their failure rates and reasons behind it. Research question: understand why TL instrumentations fail and what factors influence it. Materials and methods: Retrospective, cohort, unicentric analysis on adult patients with acute TL trauma treated with percutaneous transpedicular SSPF or LSPF. Two groups were created, according to the presence of treatment failure at follow-up. We analyzed whether age ≥65 years old, fracture segment, posterior ligamentous complex (PLC) injury, load sharing classification (LSC) score >6, type of instrumentation (SSPF vs LSPF) and abnormal bone mineral density (BMD) were associated with failure. To achieve this, we evaluated radiological parameters at the preoperative, postoperative and follow-up appointments. Results: 87 patients were included: 60 (69.0%) without failure and 27 (31.0%) with. Age ≥65 years old (aOR = 3.66, p = 0.020), PLC injury (aOR = 2.94, p = 0.048) and SSPF (aOR = 6.75, p = 0.013) were statistically significant factors contributing to failure. The first two also presented shorter times to failure (35.2 vs 69.1 months, p = 0.013, and 25.2 vs 69.1 months, p = 0.037, respectively). In PLC injured patients, there was no statistically significant difference between SSPF vs LSPF. Discussion and conclusions: We conclude that age >65 years old, PLC injury and SSPF may be correlated with instrumentation failure. The first two factors were also associated with a shorter time to failure.http://www.sciencedirect.com/science/article/pii/S2772529424014073Thoracolumbar fracturesInstrumentation failurePosterior transpedicular fixationPosterior ligamentous complex |
| spellingShingle | David Ferreira António Cruz Ana Vilela Joana Azevedo André Santos Moreira João Pereira Paulo Gil Ribeiro Nuno Oliveira Pedro Varanda Bruno Direito-Santos Thoracolumbar fractures: Factors predicting failure of percutaneous short- and long-segment posterior fixation Brain and Spine Thoracolumbar fractures Instrumentation failure Posterior transpedicular fixation Posterior ligamentous complex |
| title | Thoracolumbar fractures: Factors predicting failure of percutaneous short- and long-segment posterior fixation |
| title_full | Thoracolumbar fractures: Factors predicting failure of percutaneous short- and long-segment posterior fixation |
| title_fullStr | Thoracolumbar fractures: Factors predicting failure of percutaneous short- and long-segment posterior fixation |
| title_full_unstemmed | Thoracolumbar fractures: Factors predicting failure of percutaneous short- and long-segment posterior fixation |
| title_short | Thoracolumbar fractures: Factors predicting failure of percutaneous short- and long-segment posterior fixation |
| title_sort | thoracolumbar fractures factors predicting failure of percutaneous short and long segment posterior fixation |
| topic | Thoracolumbar fractures Instrumentation failure Posterior transpedicular fixation Posterior ligamentous complex |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424014073 |
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