J Korean Fract Soc.  2011 Oct;24(4):354-360.

The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures

• Baek SW
• Shim KD
• Park YS

Abstract

PURPOSE
Evaluate the effects of sagittal imbalance on the clinical outcomes in thoracolumbar burst fractures.
MATERIALS AND METHODS
We evaluated 11 patients who had received posterior fixation for unstable burst fractures. Radiologic assessment including the compression ratio, focal kyphotic angle and sagittal balance were obtained. The clinical outcomes were assessed by ODI, VAS and SF-36. We subdivided the patients into sagittal balance and imbalance group, and compared with clinical outcomes. The relationship between radiologic and clinical outcomes was examined using correlation analysis.
RESULTS
The radiologic assessment were changed on preoperative and postoperative as follows: mean compression ratio: 15.2%, 4.9%, mean focal kyphotic angle: 43.2degrees, 20.9degrees. The mean sagittal balance was 11.5 cm. The mean score of VAS, ODI, Physical and Mental Component Summary of SF-36 were 3.7, 45.8, 43.3 and 39.8, respectively. The ODI was significantly higher in sagittal imbalance group, and SF-36 was significantly higher in sagittal balance group (p<0.05). The VAS was correlated with compression ratio and focal kyphotic angle. The ODI and Mental Component Summary of SF-36 were correlated with sagittal imbalance.
CONCLUSION
Sagittal balance effects on the functions of spine, surgical treatment should be carefully considered with unstable burst fractures.

Keyword

Unstable burst fracture; Posterior fixation; Sagittal imbalance

MeSH Terms

Humans
Spine

Figure

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  Fig. 1 A 80-year-old female with L1 burst fracture. (A) Preoperative lateral plain radiographs shows a loss of anterior height of L1. (B) Lateral radiograph after operation shows correction of the compression ratio and focal kyphotic angle. (C) Standing lateral whole spine radiographs obtained 1 years after operation shows loss of reduction in sagittal imbalance.

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  Fig. 2 A 42-year-old male with L1 burst fracture. (A) Preoperative lateral plain radiographs shows a loss of anterior height of L1. (B) Lateral radiograph after operation shows correction of the compression ratio and focal kyphotic angle. (C) Standing lateral whole spine radiographs obtained 1 years after operation shows no reduction loss in normal sagittal alignment.

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