Abstract
Background Previous research emphasizes correcting deformities resulting from spine fractures
by restoring sagittal alignment and vertebral height. This study aims to compare radiologic
outcomes, including sagittal index (SI) and loss of vertebral body height (LVBH),
between stand-alone posterior stabilization (group I) and the posteroanterior/combined
approach (group II) in the operative management of traumatic thoracic or lumbar spine
fractures.
Methods In this retrospective single-center study, all patients with traumatic spine fractures
(T1–L5) undergoing surgical stabilization between January 1, 2015, and May 31, 2021,
were included. Two spine surgeons independently assessed imaging, recording the SI
and LVBH values at baseline, after each surgical intervention, and during follow-up
(at least 3 months posttreatment). The mean SI and LVBH values between the assessing
surgeons were utilized. Linear mixed-effects regression models, adjusted to baseline
values, compared the SI and the LVBH values between the two groups.
Results In all, 71 patients (42 men), with the median age of 38 years (interquartile range
[IQR]: 28–54) and median follow-up of 4 months (IQR: 3–17), were included. Thirty-two
patients were in group I and 39 patients were in group II. Forty fractures included
the thoracolumbar junction (T12 or L1), 15 affected the thoracic spine, and 14 the
lumbar spine. The regression model revealed superior sagittal alignment in group II,
with an adjusted mean difference for SI of –4.24 (95% confidence interval [CI]: –7.13
to –1.36; p = 0.004), and enhanced restoration of vertebral body height with an adjusted mean
difference for LVBH of 0.11 in the combined approach (95% CI: 0.02–0.20; p = 0.02). Nine postoperative complications occurred in the entire cohort (4 in group
I and 5 in group II).
Conclusions Combined posteroanterior stabilization for spine fractures improves deformities by
enhancing sagittal alignment and increasing vertebral body height, with acceptable
morbidity compared with the stand-alone posterior approach.
Keywords
spine fracture - sagittal alignment - vertebral height - comparative study - surgical
approach
