Analysis of intervertebral discs adjacent to thoracolumbar A3 fractures treated by percutaneous instrumentation and kyphoplasty.

Abstract Introduction Percutaneous instrumentation and kyphoplasty can be used to treat A3 fractures at T12-L1. However, the effect on adjacent intervertebral discs remains controversial. The purpose of this retrospective study was to analyze the degeneration of the discs adjacent to the fracture and to determine its relationship with age, vertebral body deformity and clinical scores. Materials and methods Twenty-nine patients (11 females, 18 males; average age 47 years, 27–63 years) were examined at 2.2 years’ follow-up (2.0–2.5). Radiographic measurements were taken preoperatively, postoperatively, at follow-up: regional and local kyphosis, sagittal index, vertebral body compression ratio, and disc height index. The Pfirrmann grade was determined on an MRI taken at the final assessment. Clinical scores were the pain level (VAS), EQ-5D-3L, and ODI. The relationships between Pfirrmann grades, age and radiographic parameters were analyzed. Results Local kyphosis decreased from 12.4° to 7.3° postoperatively (p  Conclusion The risk for cranial disc degeneration after percutaneous instrumentation and kyphoplasty of A3 fractures is low. The height of the cranial disc decreased after the instrumentation was removed. The risk for disc degeneration is related to age and vertebral body deformity. Disc degeneration does not appear to impact quality of life.