title: Multivariate analysis of risk factors for predicting supplementary posterior instrumentation after anterolateral decompression and instrumentation in treating thoracolumbar burst fractures.
abstract: BACKGROUND
  Although anterolateral decompression and instrumentation has several advantages in treating thoracolumbar burst fractures, the risk factors for supplementary posterior instrumentation are still unclear.
  
  
  METHODS
  We retrospectively reviewed 238 patients who underwent anterolateral decompression and instrumentation for single-level thoracolumbar burst fractures from January 2010 and March 2012. The influences of several potential risk factors that might affect supplementary posterior instrumentation were assessed using univariate and multivariate analyses.
  
  
  RESULTS
  Twenty seven patients who developed worsening back pain without neurological deterioration after the anterolateral approach treatment need further posterior instrumentation fixation. The univariate analysis showed that age, disruption of the posterior longitudinal ligament complex (PLC), and fracture level were the risk factors for supplementary posterior instrumentation. However, age and integrity of the PLC were the independent risk factors for supplementary posterior instrumentation by multivariate analyses.
  
  
  CONCLUSIONS
  Supplemental posterior instrumentation was necessary in 11.3% of cases following anterolateral decompression and instrumentation in the present study. Older age and disruption of the PLC were the independent risk factors in prediction of supplementary posterior instrumentation in treating thoracolumbar burst fractures.
authors: Department of Orthopaedics, Dongzhimen Hospital, University of Chinese Medicine, Beijing, 100700, China. jiangch110@126.com.
authors: Jiang
authors: J
authors: Chen
authors: Department of Orthopaedics, Dongzhimen Hospital, University of Chinese Medicine, Beijing, 100700, China. jiayusongorth@126.com.
authors: Yu-Song
authors: YS
authors: Jia
authors: Department of Orthopaedics, Dongzhimen Hospital, University of Chinese Medicine, Beijing, 100700, China. sunqioror@gmail.com.
authors: Qi
authors: Q
authors: Sun
authors: Department of Orthopaedics, Dongzhimen Hospital, University of Chinese Medicine, Beijing, 100700, China. Lijy@sina.com.cn.
authors: Jin-Yu
authors: JY
authors: Li
authors: Department of Orthopaedics, Dongzhimen Hospital, University of Chinese Medicine, Beijing, 100700, China. zhengqin@126.com.
authors: Chen-Ying
authors: CY
authors: Zheng
authors: Department of Orthopaedics, Dongzhimen Hospital, University of Chinese Medicine, Beijing, 100700, China. jiandu009@163.com.
authors: Jian
authors: J
authors: Du
authors: Department of Orthopaedics, Dongzhimen Hospital, University of Chinese Medicine, Beijing, 100700, China. baicx_0704@126.com.
authors: Chun-Xiao
authors: CX
authors: Bai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*
references: Spine (Phila Pa 1976). 2004 Sep 1;29(17):1901-8; discussion 1909
references: 15534413
references: Top Spinal Cord Inj Rehabil. 2012 Winter;18(1):85-99
references: 23460761
references: J Bone Joint Surg Am. 1993 Feb;75(2):162-7
references: 8423176
references: Spine (Phila Pa 1976). 1983 Nov-Dec;8(8):817-31
references: 6670016
references: Spine (Phila Pa 1976). 2008 Nov 1;33(23):2536-44
references: 18978595
references: J Neurosurg. 1995 Dec;83(6):977-83
references: 7490641
references: Spine (Phila Pa 1976). 1993 Jun 15;18(8):971-6
references: 8367784
references: J Neurosurg Spine. 2012 Jun;16(6):534-8
references: 22482423
references: Eur Spine J. 1994;3(4):184-201
references: 7866834
references: Acta Orthop. 2008 Aug;79(4):461-6
references: 18766477
references: J Spinal Disord. 1990 Mar;3(1):39-46
references: 2151984
references: J Bone Joint Surg Am. 1997 Jan;79(1):69-83
references: 9010188
references: Clin Orthop Relat Res. 1994 Sep;(306):110-9
references: 8070180
references: Spine (Phila Pa 1976). 2003 Aug 15;28(16):1794-801
references: 12923465
references: Spine (Phila Pa 1976). 2000 Aug 15;25(16):2079-84
references: 10954639
references: J Bone Joint Surg Am. 2009 May;91(5):1033-41
references: 19411450
references: J Neurosurg. 2003 Jul;99(1 Suppl):20-6
references: 12859054
references: Spine (Phila Pa 1976). 2009 Jun 15;34(14):1429-35
references: 19525832
references: Spine (Phila Pa 1976). 2006 Dec 1;31(25):2881-90
references: 17139218
references: J Am Acad Orthop Surg. 2010 Feb;18(2):63-71
references: 20118323
references: J Bone Joint Surg Am. 2003 May;85-A(5):773-81
references: 12728024
references: J Spinal Disord Tech. 2006 Jun;19(4):242-8
references: 16778657
references: J Spinal Disord Tech. 2005 Feb;18 Suppl:S15-23
references: 15699801
references: J Neurosurg Spine. 2009 Sep;11(3):295-303
references: 19769510
references: J Spinal Disord. 1989 Dec;2(4):229-33
references: 2520080
references: Clin Orthop Relat Res. 2001 Jan;(382):119-23
references: 11153978
references: Spine (Phila Pa 1976). 1993 Jun 15;18(8):955-70
references: 8367783
references: Spine (Phila Pa 1976). 2012 Jun 1;37(13):1142-50
references: 22146278
references: Neurosurgery. 2011 Mar;68(3):810-8; discussion 818-9
references: 21311306
references: Spine (Phila Pa 1976). 2003 Nov 1;28(21):2459-65
references: 14595164
references: Surg Neurol. 1998 Jun;49(6):619-26; discussion 626-7
references: 9637621
references: Spine (Phila Pa 1976). 2002 Mar 15;27(6):629-36
references: 11884911
references: Endocrinol Metab Clin North Am. 2005 Dec;34(4):1015-30, xi
references: 16310636
references: Spine (Phila Pa 1976). 2005 Oct 15;30(20):2325-33
references: 16227897
references: J Trauma. 1988 Aug;28(8):1188-94
references: 3411642
references: J Bone Miner Res. 2004 Dec;19(12):1945-54
references: 15537436
references: Emerg Radiol. 2006 Mar;12(3):124-9
references: 16374646
references: Spine (Phila Pa 1976). 1993 Dec;18(16):2423-30
references: 8303444
references: J Neurosurg Spine. 2006 Aug;5(2):117-25
references: 16925077
references: J Spinal Disord Tech. 2008 May;21(3):216-24
references: 18458594
references: Spine (Phila Pa 1976). 1994 Aug 1;19(15):1741-4
references: 7973969
references: J Spinal Disord. 1992 Jun;5(2):183-7
references: 1606376