The Effect Of Injured Intervertebral Disc On Prognosis Of T-L Fracture After Posterior Fixation Surgery

BackgroundTraditional posteriorshort-segment fixationon T-L fracture fails to deal with the adjacentinjured intervertebral discwhichalso occured with this fracture, that it may be the main reason causes kyphosis in patients after surgery.ObjectiveTo investigate the effectof injured intervertebral disc onkyphosis angle of the single vertebral thoracolumbar fractureafter treated with posteriorshort-segment fixation alone.MethodsFrom January2009 to June 2014,40 cases of thoracolumbar fractures were treated in Jinan Central Hospital, which were followed-up on time of preoperative,2 months after operation,12 months after operation and 6 months after implant removed. X-ray and MRI data were obtained on these point times. According to the preoperative MRI images,cases were divided into groups of observation group(intervertebral disc injuried,17 cases) and control group(non disc injuried,23 cases).Data of vertebral wedge angle (VWA), sagittal plane kyphosis (SPK), proximal intervertebral disc angle (PIA), sagittal index (SI) and degeneration classification of PIA from goups were analyzed statistically at each follow-up time point.Results:After a follow-up of average 23.6 months (18-30 months),SPK in 6 months after implant removed of two groups were significantly greater than 2 months after surgery (p<0.05). SPK, PIA, SI of observation group in 12 months after surgery and 6 months after implant removed were significantly greater than control group (p<0.05). The Pearce degeneration score of proximal intervertebral disc of observation group in 12 months after surgery and 6 months after implant removed were significantly higher than control group (p<0.05)Conclusion:Kyphosis will occur in thoracolumbar fracture patients after a posterior short-segment fixation alone, and the injured disc could cause more severe kyphosis chance. Angle change of the injured disc is the main reason causes serious kyphosis after surgery. It prone to degeneration after injured, which may be the reason cause angle change in this disc.