Health-related quality of life after short segment instrumentation of lumbar burst fractures

Management of lumbar burst fractures remains controversial. Surgical reduct ion/stabilization is becoming more popular; however. the functional impact of operative intervention is not clear. The purpose of this study was to as sess health-related quality of life and functional outcome after posterior fixation of lumbar burst fractures with either posterolateral or intrabody bone grafting. Twenty-four subjects were included. Radiographs and computed tomography scans were evaluated for deformity (kyphosis, vertebral compres sion, lateral angulation, lateral body height, and canal compromise) postop eratively, at 1 year, and at final follow-up (mean 3.2 years). Patients com pleted the SF 36 Health Survey and the Oswestry Low Back Pain Disability Qu estionnaire at final follow-up. Significant improvement was noted in midsag ittal diameter compromise, vertebral compression, and kyphosis. The differe nce observed between the respondents mean scores on the SF 36 was not signi ficantly different from those presented as the U.S. national average (p = 0 .053). Data from the Oswestry questionnaire indicated a similarly high leve l of function. Overall, we found posterior spinal instrumentation to correl ate with positive functional outcome based on both general health (SF 36) a nd joint-specific outcome scales (Oswestry). Posterior instrumentation prov ides sound canal decompression, kyphotic reduction, and maintains vertebral height with minimal transgression and long-term sequelae. In cases of seve re initial deformity and neurologic compromise, intrabody bone grafting is most certainly indicated; the additional support provided by a posterolater al graft may also prove beneficial as an adjunct.