Risk Factors for Insufficient Reduction After Short-Segment Posterior Fixation for Thoracolumbar Burst Fractures Does the Interval from Injury Onset to Surgery Affect Reduction of Fractured Vertebrae? Article Swipe

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Hiroyuki Aono , Shota Takenaka , Akinori Okuda , Takeshi Kikuchi , Hiroshi Takeshita , Keiji Nagata , Yasuo Ito ·

YOU? · · 2022 · Open Access · · DOI: https://doi.org/10.21203/rs.3.rs-1548654/v2

Background: Many surgeons have encountered patients who could not immediately undergo surgery to treat spinal fractures because they had associated injuries and/or because a complete diagnosis was delayed. For such patients, practitioners might assume that delays could mean that the eventual reduction would be insufficient. However, no report covered risk factors for insufficient reduction of fractured vertebra including duration from injury onset to surgery. The purpose of this study is to investigate the risk factors for insufficient reduction after short-segment fixation of thoracolumbar burst fractures. Methods: Our multicenter study included 253 patients who sustained a single thoracolumbar burst fracture and underwent short-segment fixation. We measured the local vertebral body angle (VBA) on roentgenograms, before and after surgery, and then calculated the reduction angle and reduction rate of the fractured vertebra by using the following formula: [(Preoperative VBA – Postoperative VBA) / Preoperative VBA] × 100 A multiple logistical regression analysis was performed to identify risk factors for insufficient reduction. The factors that we evaluated were age, gender, affected spine level, time elapsed from injury to surgery, inclusion of vertebroplasty with surgery, load-sharing score (LSS), AO classification (type A or B), preoperative VBA, and the ratio of canal compromise before surgery. Results: There were 140 male and 113 female patients, with an average age of 43 years, and the mean time elapsed between injury and surgery was 3.8 days. The mean reduction angle was 12°, and the mean reduction rate was 76%. The mean LSS was 6.4 points. Multiple linear regression analysis revealed that a higher LSS, a larger preoperative VBA, a younger age, and being female disposed patients to having a larger reduction angle and reduction rate. The time elapsed from injury to surgery had no relation to the quality of fracture reduction in the acute period. Conclusions: Our findings indicate that if there is no neurologic deficit, it is not necessary to hurry surgical reduction of fractured vertebrae in the acute phase.

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Medicine Reduction (mathematics) Surgery Vertebra Confidence interval Orthopedic surgery Burst fracture Fixation (population genetics) Spinal canal Internal medicine Population Psychiatry Environmental health Mathematics Geometry Spinal cord

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Type: preprint
Language: en
Landing Page: https://doi.org/10.21203/rs.3.rs-1548654/v2
PDF: https://www.researchsquare.com/article/rs-1548654/latest.pdf
OA Status: green
References: 15
Related Works: 10
OpenAlex ID: https://openalex.org/W4302007609

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DOI: https://doi.org/10.21203/rs.3.rs-1548654/v2

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Title: Risk Factors for Insufficient Reduction After Short-Segment Posterior Fixation for Thoracolumbar Burst Fractures Does the Interval from Injury Onset to Surgery Affect Reduction of Fractured Vertebrae?

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Type: preprint

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Language: en

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Publication year: 2022

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Publication date: 2022-10-05

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Authors: Hiroyuki Aono, Shota Takenaka, Akinori Okuda, Takeshi Kikuchi, Hiroshi Takeshita, Keiji Nagata, Yasuo Ito

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Landing page: https://doi.org/10.21203/rs.3.rs-1548654/v2

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Concepts: Medicine, Reduction (mathematics), Surgery, Vertebra, Confidence interval, Orthopedic surgery, Burst fracture, Fixation (population genetics), Spinal canal, Internal medicine, Population, Psychiatry, Environmental health, Mathematics, Geometry, Spinal cord

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abstract_inverted_index.female	208, 266
abstract_inverted_index.having	270
abstract_inverted_index.higher	255
abstract_inverted_index.injury	61, 174, 223, 282
abstract_inverted_index.larger	258, 272
abstract_inverted_index.level,	170
abstract_inverted_index.linear	249
abstract_inverted_index.phase.	323
abstract_inverted_index.report	48
abstract_inverted_index.single	96
abstract_inverted_index.spinal	15
abstract_inverted_index.years,	216
abstract_inverted_index.average	212
abstract_inverted_index.because	17, 23
abstract_inverted_index.between	222
abstract_inverted_index.covered	49
abstract_inverted_index.elapsed	172, 221, 280
abstract_inverted_index.factors	51, 75, 156, 161
abstract_inverted_index.gender,	167
abstract_inverted_index.period.	297
abstract_inverted_index.points.	247
abstract_inverted_index.purpose	66
abstract_inverted_index.quality	290
abstract_inverted_index.surgery	12, 225, 284
abstract_inverted_index.undergo	11
abstract_inverted_index.younger	262
abstract_inverted_index.Abstract	0
abstract_inverted_index.However,	46
abstract_inverted_index.Methods:	86
abstract_inverted_index.Multiple	248
abstract_inverted_index.Results:	201
abstract_inverted_index.affected	168
abstract_inverted_index.analysis	150, 251
abstract_inverted_index.complete	25
abstract_inverted_index.deficit,	308
abstract_inverted_index.delayed.	28
abstract_inverted_index.disposed	267
abstract_inverted_index.duration	59
abstract_inverted_index.eventual	41
abstract_inverted_index.findings	300
abstract_inverted_index.fixation	81
abstract_inverted_index.formula:	135
abstract_inverted_index.fracture	99, 292
abstract_inverted_index.identify	154
abstract_inverted_index.included	90
abstract_inverted_index.indicate	301
abstract_inverted_index.injuries	21
abstract_inverted_index.measured	105
abstract_inverted_index.multiple	147
abstract_inverted_index.patients	6, 92, 268
abstract_inverted_index.relation	287
abstract_inverted_index.revealed	252
abstract_inverted_index.surgeons	3
abstract_inverted_index.surgery,	117, 176, 181
abstract_inverted_index.surgery.	64, 200
abstract_inverted_index.surgical	315
abstract_inverted_index.vertebra	57, 130
abstract_inverted_index.diagnosis	26
abstract_inverted_index.evaluated	164
abstract_inverted_index.fixation.	103
abstract_inverted_index.following	134
abstract_inverted_index.fractured	56, 129, 318
abstract_inverted_index.fractures	16
abstract_inverted_index.including	58
abstract_inverted_index.inclusion	177
abstract_inverted_index.necessary	312
abstract_inverted_index.patients,	31, 209
abstract_inverted_index.performed	152
abstract_inverted_index.reduction	42, 54, 78, 122, 125, 231, 238, 273, 276, 293, 316
abstract_inverted_index.sustained	94
abstract_inverted_index.underwent	101
abstract_inverted_index.vertebrae	319
abstract_inverted_index.vertebral	108
abstract_inverted_index.associated	20
abstract_inverted_index.calculated	120
abstract_inverted_index.compromise	198
abstract_inverted_index.fractures.	85
abstract_inverted_index.logistical	148
abstract_inverted_index.neurologic	307
abstract_inverted_index.reduction.	159
abstract_inverted_index.regression	149, 250
abstract_inverted_index.Background:	1
abstract_inverted_index.encountered	5
abstract_inverted_index.immediately	10
abstract_inverted_index.investigate	72
abstract_inverted_index.multicenter	88
abstract_inverted_index.Conclusions:	298
abstract_inverted_index.Preoperative	142
abstract_inverted_index.insufficient	53, 77, 158
abstract_inverted_index.load-sharing	182
abstract_inverted_index.preoperative	191, 259
abstract_inverted_index.Postoperative	139
abstract_inverted_index.insufficient.	45
abstract_inverted_index.practitioners	32
abstract_inverted_index.short-segment	80, 102
abstract_inverted_index.thoracolumbar	83, 97
abstract_inverted_index.[(Preoperative	136
abstract_inverted_index.classification	186
abstract_inverted_index.vertebroplasty	179
abstract_inverted_index.roentgenograms,	113
cited_by_percentile_year
countries_distinct_count	2
institutions_distinct_count	7
citation_normalized_percentile.value	0.24317774
citation_normalized_percentile.is_in_top_1_percent	False
citation_normalized_percentile.is_in_top_10_percent	False