Does kyphotic deformity correlate with functional outcomes in fractures at the thoracolumbar junction treated by 360° instrumented fusion?

  • Ronald SchulzEmail author
  • Robert P. Melcher
  • Miguel Cumsille Garib
  • Hermann Schulz
  • Karen Weissman
  • Jürgen Harms
Original Article


Sagittal balance and its relationship with back pain and functional outcomes has become an important factor in the management of thoracolumbar fractures. The kyphosis threshold at the thoracolumbar junction (TLJ) that produces a significant functional impairment remains unclear. Ninety-four patients who were treated surgically for TLJ fractures were evaluated after a follow-up period of 2–10 years. Functional evaluation based on the Oswestry and Hannover Scores (HS) was performed. Additionally, such patients underwent clinical and radiological evaluation. A significant inversely proportional correlation between the HS and the degrees of local kyphosis (“K-Angle”) (p = 0.0172) was found. A significant directly proportional correlation between Oswestry Score and “K-Angle” (p = 0.0142) was found. Significantly poorer scores with both measurement tools (Hannover and Oswestry Scores) were found in patients with a kyphosis higher than 12°.


Thoracolumbar fractures Sagittal balance Functional outcomes Kyphosis Functional impairment Oswestry Disability Index (ODI) Hannover Score Cobb’s angle 


Conflict of interest

The corresponding author developed this study in the frame of a research fellowship supported by an academic institution without relationship with the biomedical or pharmacological industry (Deutscher Akademischer Austauschdienst). No other financial support, direct or indirect, was received by any of the authors.


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Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  • Ronald Schulz
    • 1
    Email author
  • Robert P. Melcher
    • 2
  • Miguel Cumsille Garib
    • 3
  • Hermann Schulz
    • 4
  • Karen Weissman
    • 3
  • Jürgen Harms
    • 2
  1. 1.Hospital Clínico Universidad de ChileSantiago de ChileChile
  2. 2.Klinikum Karlsbad-LangensteinbachKarlsbad-LangensteinbachGermany
  3. 3.Facultad de MedicinaUniversidad de ChileSantiago de ChileChile
  4. 4.Facultad de MedicinaUniversidad de Los AndesSantiago de ChileChile

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