Long-term functional results after short-segment pedicle fixation of thoracolumbar fractures

Abstract

Purpose: A retrospective study to assess the health-related quality of life in patients undergoing posterior fixation of thoracolumbar fractures, and to compare the outcome with norm scores and HRQL in patients undergoing surgical treatment for degenerative conditions of the spine.

Methods: The study population consisted of 93 consecutive patients surgically treated for a thoracolumbar fracture from 2005 to 2009. All patients underwent posterior pedicle screw fixation and fusion. 83 patients were available for follow-up. Three questionnaires reflecting health-related quality of life (HRQL) were mailed to the patients: SF-36, ODI, and EQ-5D.

Results: 52 men and 31 women were operated with an average age at the time of surgery of 46 years. All fractures were AO-type A3.1 and A3.2 with L1 being the primary fracture level. All patients were neurologically intact; Frankel E. The overall response rate on the questionnaires was 75% with no significant differences between responders and non-responder on basic demographic characteristics. The median follow up period was 3.8 years (range 2-6 years). The scores on all three questionnaires were significantly reduced compared to the national norm scores (p<0.05).

Conclusion: Health-related quality of life is affected several years after short segment posterior instrumentation of thoracolumbar fractures without neurological deficit.

Keywords: EQ5D; Fracture; ODI; Outcome; SF36; Thoracolumbar.