LONG-TERM FOLLOW-UP RESULTS OF THORACOLUMBAR FRACTURES AFTER POSTERIOR INSTRUMENTATION

Study Design. This retrospective study examined the hospital records o f 60 patients with thoracolumbar fractures treated with posterior fusi on and spinal instrumentation. The mean follow-up period was 66 months . Objectives. The goal of this study was to evaluate and analyze the l ong-term outcome and socioeconomic conditions of patients who had sust ained a thoracolumbar fracture. Summary of Background Data. In four pa tients, additional spinal injuries were detected. Three of the patient s evaluated with magnetic resonance imaging showed cord contusion and edema. In six patients, ruptured disc fragments were detected by preop erative magnetic resonance imaging or during surgery. Methods. Long-te rm follow-up results in 60 patients with unstable thoracolumbar fractu res treated with posterior fusion and spinal instrumentation were anal yzed. Neurologic outcomes and independence in function and daily livin g activities were reviewed. Age, sex, mechanism of injury, associated injuries to the spinal cord, and associated injuries to the spinal cor d and other systems were analyzed. Fractures were classified according to the system of Ferguson and Alien. Results. The patients with incom plete spinal cord injury showed significant functional improvement. Du ring the follow-up period, 28 patients showed neurologic improvement. Postoperative complications occurred in 11 patients. Five patients req uired late rod removal because of rod dislocation. Conclusion. Regardl ess of neurologic recovery, most patients reported some disability, us ually caused by pain. Inability to return to alternative jobs resulted from insufficient educational background rather than neurologic dysfu nction. Advanced academic achievement was the single most important pr edictive factor of ability to return to work.