[Investigation of the health-related quality of life after a dorso ventral stabilization of the thoracolumbar junction]

Abstract

Objective: Combined dorsoventral stabilization provides superior mechanical stability in the operative treatment of thoracolumbar spine fractures. Currently, there are no data available reflecting the quality of life in trauma patients following the combined procedure. The aim of this investigation was to study the health-related quality of life after dorsoventral stabilization of the thoracolumbar junction using the SF-36 Health Survey.

Methods: In order to assess the quality of life, 30 patients from a consecutive series with unstable fractures of the thoracolumbar junction were investigated in a clinical study. After posterior stabilization with an internal fixator (USS, Synthes),anterior arthrodesis was performed subsequently by autogenous iliac bone grafting in combination with osteosynthesis (MACS, Aesculap; VentroFix, Synthes). The quality of life was investigated 2 years after surgery. Additionally, plain X-rays were obtained and the degree of kyphotic deformation was measured.

Results: The evaluation of the data obtained from the SF-36 revealed a reduced quality of life, especially regarding the "physical functioning index", the "bodily pain index", and the "emotional functioning index". Of the patients, 42% still suffered from moderate to severe pain. Measurement of the Cobb angle showed a slight loss of correction without occurrence of a relevant kyphotic deformity. Our statistical analyses did not show any correlation between the data obtained from the SF-36 and the clinical results. Especially there was no correlation between the "bodily pain index" and the Cobb angle ( r=0.112, Spearman's rank order correlation).

Conclusion: The patients studied here showed a reduced quality of life 2 years after dorsoventral stabilization of the thoracolumbar junction predominantly resulting in long-term pain symptoms. As these findings could not be related to the radiological results (i.e., the occurrence of a kyphotic deformation), other factors such as injury of the motion segment of the spine and the major surgical procedure have to be considered as the main reasons for the reduced quality of life. In summary, it can be concluded that the SF-36 is a suitable tool for the investigation of the postoperative outcome following dorsoventral stabilization of the thoracolumbar junction in trauma patients.