RESEARCH ARTICLE
Radiological Prediction of Posttraumatic Kyphosis After Thoracolumbar Fracture
Inez Curfs1, *, Bernd Grimm2, Matthijs van der Linde1, Paul Willems3, Wouter van Hemert1
Article Information
Identifiers and Pagination:
Year: 2016Volume: 10
First Page: 135
Last Page: 142
Publisher ID: TOORTHJ-10-135
DOI: 10.2174/1874325001610010135
Article History:
Received Date: 10/6/2015Revision Received Date: 23/12/2015
Acceptance Date: 30/12/2015
Electronic publication date: 30/05/2016
Collection year: 2016
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Abstract
Objectives:
Classification methods that are currently being used for clinical decision making in thoracolumbar fractures, are limited by reproducibility and prognostic value. Additionally, they do not include kyphosis. As a posttraumatic kyphosis is related to persistent pain, it is of importance to determine a risk of posttraumatic kyphosis based on fracture type and patient characteristics.
Purpose:
To determine risk factors (AO classification, age, gender, localization) that may lead to progressive kyphosis after a thoracolumbar fracture.
Materials and Methods:
Retrospective radiographic analysis of a consecutive patientcohort that presented in our clinic with a traumatic fracture of the thoracolumbar spine between 2004 and 2011. Cobb angle, Gardner angle, vertebral compression angle and anterior vertebral body compression were measured on plain radiographs, direct post-trauma and at follow-up.
Results:
Age and localization are not significantly correlated, but there seems to be an increased risk of progression of kyphosis in age > 50 years and fractures localized at Th12 or L1. A3 type fractures are significantly more at risk for posttraumatic kyphosis compared to A1 and A2 type fractures. 30-50% of the A3 type fractures have an end Gardner angle and end vertebral compression angle of more than 20 degrees.
Conclusion:
AO-type A3 fractures appear to be at risk of progression of kyphosis. Localization at Th12-L1 and age above 50 years seem to be risk factors for significant posttraumatic kyphosis. These findings should be used in patient counseling and a meticulous evaluation by weekly radiographs is recommended to determine the treatment strategy of thoracolumbar fractures.
