Background:

Posterior fixation without fusion can treat thoracolumbar and lumbar traumatic fractures effectively in certain cases. However, whether patients benefit from implant removal, and the correlation between the range of motion (ROM) of the involved segments and the removal time have not been determined.

Methods:

From 2018 to 2020, We retrospectively reviewed data of patients with AO spine type-A or B thoracolumbar or lumbar traumatic fractures who underwent implant removal. 17 patients (Group A), 21 patients (Group B), and 12 patients (Group C) underwent implant removal following the index surgery within 12 months, between 12 to 24 months, and over 24 months, respectively. Clinical and radiological outcomes, including visual analog scale (VAS) for back pain, patient satisfaction, Oswestry disability index (ODI) and EuroQol five dimensions questionnaire (EQ-5D) for quality of life and segmental ROM were analyzed.

Results:

The average follow-up time was 9.1±5.7 months after implant removal. There were no significant differences in VAS and patient satisfaction among three groups at the same observation time point. Patients in group A gained the lowest ODI and highest EQ-5D scores after removal and at final follow-up than those in group B and C. The best ROM was obtained in group A followed by group B and C (11.5±6.2°, 5.5±1.6° and 2.4±0.6°, respectively).

Conclusions:

Immobilization of the involved segments over 24 months may lead to loss of ROM. Regained segmental ROM is correlated negatively with implant removal time, and removing within 12 months promises a better ROM and quality of life.