Pelvic incidence in thoracolumbar fractures: Is there an impact?

Introduction: In trauma, we can perform a lateral radiography of the lumbosacral hinge taking the femoral heads if we include it in the initial lesion assessment. Thus, the pelvic incidence informs about the type of back as described by Roussouly.

Aim: To describe the clinical and radiological results of these types of back which are operated on for a thoracolumbar fracture.

Methods: We recorded the clinical, radiological data and the characteristics of the fracture of 120 patient operated on for a thoracolumbar spine fracture over a period of 14 years between February 2005 and July 2019. We studied the deformation according to Regional traumatic angulation (ART), Sagittal Farcy Index (SIF), Gardner Segment Kyphotic Deformity (GSKD). Functional evaluation was carried out according to the Denis Pain Scale. Radiological evaluation was based on relative gain and loss.

Results: In individuals with low pelvic incidence, a prevalence of 72% was observed for type A fracture, whereas types B and C accounted for 45.9% (P<0.05) for backs with high pelvic incidence. The Denis Pain Scale score indicated that 90% of individuals with low incidence backs had scores below 3, whereas only 65.6% of those with high incidences had scores below 3 (P<0.05). The loss of correction for backs with low incidences was measured at 1.2°, while for backs with high incidences, it was 3° (p<0.05).

Conclusion: Fractures on backs with low pelvic incidence considered as stiff backs are more frequently of type A, with better functional results and less losses.