Radiological-functional Correlation of Surgically Treated Thoracolumbar Hinge Fractures.

Abstract

Retrospective review of a case series. The study investigates the relationship between surgical angular correction in fractures of the thoracolumbar junction (T11-L2 vertebrae) and long-term functional outcomes, as measured by the Oswestry Disability Index (ODI). We analyze whether there is a significant correlation between the postoperative Farcy index and the ODI score at 2 years, with the aim of improving surgical planning and optimizing percutaneous fixation and vertebral arthrodesis treatments. Some studies associate postoperative angular correction with improved ODI scores, particularly with percutaneous fixation, while others find no correlation. The TLICS system aids treatment decisions, and percutaneous fixation reduces complications and accelerates recovery, though spinal fusion does not always ensure better functional outcomes. The study includes 82 patients treated between 2017 and 2021 at the Miguel Servet University Hospital (Zaragoza) using surgical instrumentation. The Farcy index was used to measure vertebral deformity before and after surgery, and functional outcomes were assessed through the ODI. The variables analyzed included age, sex, Farcy index, and postoperative angle. Linear regression models and analysis of covariance (ANCOVA) were used to study the relationship between these variables and the ODI. The analysis showed that a higher baseline deformity, reflected in a high Farcy index, is significantly associated with higher ODI scores, indicating greater disability. Age was also an important factor, correlating positively with ODI. Postoperative angle and sex did not show significant associations with functional outcomes. This study suggests that proper correction of vertebral deformity is crucial to improving functional outcomes in patients with thoracolumbar fractures. The findings support the use of the Farcy index as a predictor of long-term functional recovery and suggest the need for personalized approaches in surgical treatment.