Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine
Background: Benefit of implant removal in spine surgery remains unclear. While there is mostly consensus about necessity of implant removal in posterior-only stabilized patients, the effect of this measure in cases with combined anterior-posterior stabilization is undetermined. With this work we pre...
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Elsevier
2024-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529424001012 |
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| author | André El Saman Simon Lars Meier Florian Rüger Jason Alexander Hörauf Ingo Marzi |
| author_facet | André El Saman Simon Lars Meier Florian Rüger Jason Alexander Hörauf Ingo Marzi |
| author_sort | André El Saman |
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| description | Background: Benefit of implant removal in spine surgery remains unclear. While there is mostly consensus about necessity of implant removal in posterior-only stabilized patients, the effect of this measure in cases with combined anterior-posterior stabilization is undetermined. With this work we present a retrospective analysis of 87 patients with traumatic thoracolumbar vertebral fractures concerning quality of life (QOL), loss of correction (LOC) and range of motion (ROM). The effect of implant removal on the outcome 18–74 months after surgery was analyzed to determine how implant removal affects radiologic, functional and quality-of life-related parameters. Patients and methods: 87 patients suffering from a traumatic vertebral body fracture (T11 – L2) were included. Quality of life was determined using four different scoring systems (SF 36, VAS, Oswestry, LBOS). Clinical examination included range of motion. Radiologic findings were correlated with QOL. Results: Patients with removal of the internal fixator had a trend towards better range of motion than patients with posterior instrumentation left in place. Radiologic findings showed no correlation to QOL. Implant removal led to better values in Oswestry and SF-36. 69% of patients after removal reported a reduction of their symptoms.All patients with persistence of severe pain after implant removal belonged to subgroup II.2 (anterior monosegmental fusion with bone graft) Conclusion: Removal of the internal fixator can lead to a reduction of symptoms. Patient selection is crucial for successful indication. Radiologic findings do not correlate with QOL. |
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| institution | OA Journals |
| issn | 2772-5294 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
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| series | Brain and Spine |
| spelling | doaj-art-8a0d9ff1559e4a8181cf1c2d1a1061982025-08-20T02:38:06ZengElsevierBrain and Spine2772-52942024-01-01410284510.1016/j.bas.2024.102845Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spineAndré El Saman0Simon Lars Meier1Florian Rüger2Jason Alexander Hörauf3Ingo Marzi4Corresponding author.; Department of Trauma, Hand and Reconstructive Surgery, Goethe-University Medical Center, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, Goethe-University Medical Center, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, Goethe-University Medical Center, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, Goethe-University Medical Center, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, GermanyDepartment of Trauma, Hand and Reconstructive Surgery, Goethe-University Medical Center, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, GermanyBackground: Benefit of implant removal in spine surgery remains unclear. While there is mostly consensus about necessity of implant removal in posterior-only stabilized patients, the effect of this measure in cases with combined anterior-posterior stabilization is undetermined. With this work we present a retrospective analysis of 87 patients with traumatic thoracolumbar vertebral fractures concerning quality of life (QOL), loss of correction (LOC) and range of motion (ROM). The effect of implant removal on the outcome 18–74 months after surgery was analyzed to determine how implant removal affects radiologic, functional and quality-of life-related parameters. Patients and methods: 87 patients suffering from a traumatic vertebral body fracture (T11 – L2) were included. Quality of life was determined using four different scoring systems (SF 36, VAS, Oswestry, LBOS). Clinical examination included range of motion. Radiologic findings were correlated with QOL. Results: Patients with removal of the internal fixator had a trend towards better range of motion than patients with posterior instrumentation left in place. Radiologic findings showed no correlation to QOL. Implant removal led to better values in Oswestry and SF-36. 69% of patients after removal reported a reduction of their symptoms.All patients with persistence of severe pain after implant removal belonged to subgroup II.2 (anterior monosegmental fusion with bone graft) Conclusion: Removal of the internal fixator can lead to a reduction of symptoms. Patient selection is crucial for successful indication. Radiologic findings do not correlate with QOL.http://www.sciencedirect.com/science/article/pii/S2772529424001012SpineFractureOutcomeImplant removalQuality of lifeQOL |
| spellingShingle | André El Saman Simon Lars Meier Florian Rüger Jason Alexander Hörauf Ingo Marzi Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine Brain and Spine Spine Fracture Outcome Implant removal Quality of life QOL |
| title | Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine |
| title_full | Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine |
| title_fullStr | Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine |
| title_full_unstemmed | Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine |
| title_short | Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine |
| title_sort | impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine |
| topic | Spine Fracture Outcome Implant removal Quality of life QOL |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424001012 |
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