NDLI: Use of the sagittal Cobb* angle to guide the rod bending in the treatment of thoracolumbar fractures: a retrospective clinical study

Content Provider	Springer Nature : BioMed Central
Author	Shi, Zongpo Wang, Gang Jin, Zhen Wu, Tao Wang, Haoran Sun, Jinpeng Nicolas, Yap San Min Rupesh, K. C. Yang, Kaixiang Liu, Jun
Abstract	Background Pedicle screw fixation is a well-established technique for thoracolumbar fracture. A large number of studies have shown that the bending angle of the connecting rod has a significant correlation with the postoperative spinal stability. However, no studies have confirmed an objective indicator to guide the bending angle of the connecting rod during the operation. Our study aims to define a sagittal Cobb* angle to guide the bending angle of the connecting rod during surgery. Methods The frontal and lateral X-ray films in 150 cases of normal thoracolumbar spine were included to measure the normal spinal sagittal Cobb* angle in each segment. The patients who underwent single segment thoracolumbar fractures and pedicle screw internal fixation surgery were included. The radiological parameters included lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), pelvic incidence (PI), sagittal vertical axis (SVA), and sacral slope (SS) were measured. The incidence of adjacent segment degeneration (ASD) 2 years after surgery was measured. Results The average values of normal sagittal Cobb* angle in each segment were − 5.196 ± 3.318° (T12), 2.279 ± 3.324° (L1), 7.222 ± 2.798° (L2), and 12.417 ± 11.962° (L3), respectively. The LL in the three groups was 35.20 ± 9.12°, 46.26 ± 9.68°, and 54.24 ± 15.31°, respectively. Compared with the normal group, there were significant differences in group A and group C, respectively (p < 0.05). The results were similar in the parameters of TL, PT, and SS. The incidences of SVA > 50 mm in group A, group B, and group C were 23.33%, 12.50%, and 19.23%, respectively. The parameter of PI in three groups was 41.36 ± 12.69, 44.53 ± 15.27, and 43.38 ± 9.85°, respectively. The incidences of ASD in group A, group B, and group C 2 years after surgery were 21.67%, 13.75%, and 17.95%, respectively. Conclusions The study confirmed that the sagittal Cobb* angle can be used as a reference angle for bending rods. When the bending angle of the connecting rod is 4 to 8° greater than the corresponding segment sagittal Cobb* angle, the patient’s spinal sagittal stability is the best 2 years after the operation.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-020-02115-5.pdf
Ending Page	6
Page Count	6
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-020-02115-5
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2020-12-01
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Thoracolumbar fracture Sagittal Cobb* angle Bending rods Spinal sagittal parameters Adjacent segment degeneration
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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