• Ke Wang, Zeng-Jie Zhang, Jian-Le Wang, Chong-An Huang, Qi-Shan Huang, Jian Chen, Yao-Sen Wu, Yan Lin, Xiang-Yang Wang, Jiao-Xiang Chen, and Sun-Ren Sheng.
• Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Ouhai, Wenzhou, China; Key Laboratory of Orthopaedics of Zhejiang Province, Zhejiang, China; The Second School of Medicine, Wenzhou Medical University, Ouhai, Wenzhou, China.
• World Neurosurg. 2018 Nov 1; 119: e475-e481.

ObjectiveTo determine whether radiographic findings associated with thoracolumbar burst fractures could be predictors of failure of short-segment posterior instrumentation with insertion screw at the fracture level (SSPI-f).MethodsSeventy-five patients with thoracolumbar burst fracture surgically treated by SSPI-f were enrolled in the study and divided into 2 groups: a reduction group (n = 46) and a failed-reduction group (n = 29). Radiographic data including local kyphosis, Cobb angle, anterior vertebral height, posterior vertebral height (PVH), anterior/posterior vertebral height ratio, interpedicle distance (IPD), bony compress area, bony fracture area, and compress-fracture area of the fractured vertebra and clinical data including age and neurologic function were also analyzed. t test, Pearson χ2 test, and binary logistic regression were performed to compare the values.ResultsThe PVH in the failed-reduction group was smaller than that of the reduction group (83.5% ± 7.2% and 89.1% ± 5.4%, respectively) (P = 0.001). The IPD differed between the reduction and failed-reduction group (18.0% ± 4.1% and 25.8% ± 7.1%, respectively) (P < 0.001). There was a statistical difference between the 2 groups in delayed time before surgery (P = 0.008). There was a significant difference of bony fracture area and compress-fracture area of the fractured vertebra between the failed-reduction and reduction group (both P < 0.001). Binary logistic regression showed that IPD was a risk factor of reduction failure of SSPI-f (P = 0.001).ConclusionsThese results showed that increased IPD was a risk factor of failed-reduction of SSPI-f in managing thoracolumbar burst fractures, particularly for patients with neurologic deficit, whereas local kyphosis, Cobb angle, anterior vertebral height, PVH, anterior/posterior vertebral height ratio, bony compress area, bony fracture area, and compress-fracture area of the fractured vertebra were not.Copyright © 2018 Elsevier Inc. All rights reserved.

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