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The Role of Cross-Link Augmentation on Fusion Rate and Patient Satisfaction Among Patients With Traumatic Thoracolumbar Spinal Fracture: A Randomized Clinical Trial; [El Papel Del Aumento De Los Enlaces Cruzados En La Tasa De Fusion Y La Satisfaccion Del Paciente Entre Los Pacientes Con Fractura Traumatica De La Columna Vertebral Toracolumbar: Un Ensayo Clinico Aleatorizado] Publisher Pubmed



Mirzaei F1 ; Iranmehr A2 ; Shokouhi G1 ; Khadivi M2 ; Shakeri M1 ; Namvar M2 ; Rafiei E1 ; Matloubi B1
Authors
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Authors Affiliations
  1. 1. Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran
  2. 2. Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran

Source: Neurocirugia Published:2022


Abstract

Introduction and objectives: Most of the studies evaluating the effect of cross links on spinal stability are performed in vitro on porcine or human spine segments and there is limited data regarding clinical benefits of cross link augmentation in traumatic injuries. In this study we aimed to evaluate the effects of cross-links insertion between rods on the fusion rates and post-surgical patients’ satisfaction among patients with traumatic thoracolumbar fractures who underwent posterior spinal fixation with pedicle screws. Materials and methods: This study was conducted as a randomized clinical trial on 60 patients suffering from traumatic thoracolumbar vertebrae fractures. Patients were randomized into three groups: A (without any cross-link), B (One cross-link insertion) and C (two cross-links insertion). Six months after surgery outcomes were evaluated: fusion rates (plain X-ray and CT scan), Back pain (Visual Analog Scale) and patient satisfaction (fair, good, excellent). Results: In group A 13 (65%) patients had structured bone fusion, but in 7 (35%) patients bone fusion was not observed. In both groups B and C, 19 patients (95%) had bone fusion, but only in 1 patient (5%) fusion failed (p = 0.009). In group A, fair satisfaction has the highest rate (8 patients (40%)) compared to the other groups. The highest reported severity of back pain was observed in group A while the lowest reported intensity of back pain was related to group B (p = 0.001). Conclusions: Adding cross link to posterior spinal fixations of patients with traumatic thoracolumbar fractures can be associated with better final fusion results and patients’ satisfaction. However it is necessary to design studies with greater sample sizes to confirm this theory. Trial registration number: IRCT20120527009878N3. © 2021 Sociedad Espanola de Neurocirugia