Abstract
Purpose
Thoracolumbar junction burst fractures remain a challenging problem due to controversy over the treatment choice of short- or long-segment posterior fixation. The aim of the present study was to compare life quality and sexual function of patients after short- and long-segment posterior fixations in the treatment of thoracolumbar junction burst fractures.
Methods
In this prospective, randomized study, 24 sexually active male patients diagnosed with thoracolumbar junction burst fractures were randomly assigned to either the short-segment posterior fixation (SSPF) group or the long-segment posterior fixation group (LLPF). The exclusion criteria were rheumatological disease and spinal surgery history. There were no significant differences in age, body mass index or smoking habits between the groups. The life quality score of EQ-5D and the International Index of erectile function (IIEF-5) score of male patients and the Female Sexual Function Index (FSFI) score of female partners were recorded preoperatively and 1 year after surgery.
Results
The mean age of patients in the SSPF and LSPF groups was 44.58 and 42.92 years, respectively. There were no statistically significant differences between the groups in the preoperative EQ-5D and IIEF-5 scores of male patients and the FSFI score of their partners. Postoperatively, the EQ-5D scores (p = 0.011) and IIEF-5 scores (p = 0.000) of male patients and the FSFI score of their partners (p = 0.001) were better in the short-segment group.
Conclusions
Patients treated with SSPF have better sexual function and life quality with their partners compared to those treated with LSPF. The main clinical relevance of this study is that the impact of the choice of short or long-segment treatment on postoperative sexual function and life quality should be considered by surgeons when performing posterior fixation after thoracolumbar junction burst fractures.
Similar content being viewed by others
References
Scheer JK, Bakhsheshian J, Fakurnejad S, Oh T, Dahdaleh NS, Smith ZA (2015) Evidence-based medicine of traumatic thoracolumbar burst fractures: a systematic review of operative management across 20 years. Global Spine J 5:73–82
Briem D, Behechtnejad A, Ouchmaev A, Morfeld M, Schermelleh-Engel K, Amling M, Rueger JM (2007) Pain regulation and health-related quality of life after thoracolumbar fractures of the spine. Eur Spine J 16:1925–1933
Boucher M, Bhandari M, Kwok D (2001) Health-related quality of life after short segment instrumentation of lumbar burst fractures. J Spinal Disord 14:417–426
Moelmer M, Gehrchen M, Dahl B (2013) Long-term functional results after short-segment pedicle fixation of thoracolumbar fractures. Injury 44:1843–1846
Wei FX, Liu SY, Liang CX, Li HM, Long HQ, Yu BS, Chen BL, Chen KB (2010) Transpedicular fixation in management of thoracolumbar burst fractures: monosegmental fixation versus short-segment instrumentation. Spine (Phila Pa 1976) 1(35):E714–E720
Butt MF, Farooq M, Mir B, Dhar AS, Hussain A, Mumtaz M (2007) Management of unstable thoracolumbar spinal injuries by posterior short segment spinal fixation. Int Orthop 35:1639–1645
Leferink VJ, Keizer HJ, Oosterhuis JK, van der Sluis CK, ten Duis HJ (2003) Functional outcome in patients with thoracolumbar burst fractures treated with dorsal instrumentation and transpedicular cancellous bone grafting. Eur Spine J 12:261–267
Gnanenthiran SR, Adie S, Harris IA (2012) Nonoperative versus operative treatment for thoracolumbar burst fractures without neurologic deficit: a meta-analysis. Clin Orthop Relat Res 470:567–577
Stadhouder A, Buskens E, de Klerk LW, Verhaar JA, Dhert WA, Verbout AJ, Vaccaro AR, Oner FC (2008) Traumatic thoracic and lumbar spinal fractures: operative or nonoperative treatment: comparison of two treatment strategies by means of surgeon equipoise. Spine (Phila Pa 1976) 20(33):1006–1017
Thormann U, Erli HJ, Brügmann M, Szalay G, Schlewitz G, Pape HC, Schnettler R, Alt V (2013) Association of clinical parameters of operatively treated thoracolumbar fractures with quality of life parameters. Eur Spine J 22:2202–2210
Jansson KÅ, Granath F (2011) Health-related quality of life (EQ-5D) before and after orthopedic surgery. Acta Orthop 82:82–89
Malavaud B, Mouzin M, Tricoire JL, Gamé X, Rischmann P, Sarramon JP, Puget J (2000) Evaluation of male sexual function after pelvic trauma by the International Index of Erectile Function. Urology 55:842–846
Wright JL, Nathens AB, Rivara FP, MacKenzie EJ, Wessells H (2006) Specific fracture configurations predict sexual and excretory dysfunction in men and women 1 year after pelvic fracture. J Urol 176:1540–1545
Mallet R, Tricoire JL, Rischmann P, Sarramon JP, Puget J, Malavaud B (2005) High prevalence of erectile dysfunction in young male patients after intramedullary femoral nailing. Urology 65:559–563
Mannion AF, Junge A, Elfering A, Dvorak J, Porchet F, Grob D (2009) Great expectations: really the novel predictor of outcome after spinal surgery? Spine (Phila Pa 1976) 1(34):1590–1599
Schouten R, Lewkonia P, Noonan VK, Dvorak MF, Fisher CG (2015) Expectations of recovery and functional outcomes following thoracolumbar trauma: an evidence-based medicine process to determine what surgeons should be telling their patients. J Neurosurg Spine 22:101–111
Suzuki N, Ogikubo O, Hansson T (2009) The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation. Eur Spine J 18:77–88
Tezeren G, Kuru I (2005) Posterior fixation of thoracolumbar burst fracture: short-segment pedicle fixation versus long-segment instrumentation. J Spinal Disord Tech 18:485–488
Berg S, Fritzell P, Tropp H (2009) Sex life and sexual function in men and women before and after total disc replacement compared with posterior lumbar fusion. Spine J 9:987–994
Hägg O, Fritzell P, Nordwall A, Swedish Lumbar Spine Study Group (2006) Sexual function in men and women after anterior surgery for chronic low back pain. Eur Spine J 15:677–682
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Cankaya, D., Balci, M., Deveci, A. et al. Better life quality and sexual function in men and their female partners with short-segment posterior fixation in the treatment of thoracolumbar junction burst fractures. Eur Spine J 25, 1128–1134 (2016). https://doi.org/10.1007/s00586-015-4145-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-015-4145-1