Journal article
Management Options in Thoracolumbar Burst Fractures
Surgical neurology, Vol.49(6), pp.619-627
1998
DOI: 10.1016/S0090-3019(97)00527-2
PMID: 9637621
Abstract
Background
Both surgery and recumbency have been adopted in the treatment of spinal fractures. Herein we present the indications for each, and our experience with thoracolumbar junction (T12, L1 and L2) burst fractures.
Methods
Sixty-eight patients with thoracolumbar burst fractures were treated operatively in 36 cases, and nonoperatively in 32 with recumbency for 1–6 weeks. Treatment was based on clinical and radiological criteria. Eighty-one percent of the recumbency patients, but only 14% of the surgical patients were intact on admission. Patients were followed for a mean ± SD of 9 ± 10 months in the recumbency group, and 21 ± 21 months in the surgical group.
Results
Neurological improvement and progressive angular deformity occurred in both groups. The cost of recumbency in our patients was nearly half that of those who required surgery, though the length of hospitalization between the two groups was similar at 1 month ± 2 weeks.
Conclusion
The above study emphasizes that the selection of operative versus nonoperative treatment in burst fractures should not be random but based on clinical as well as radiological criteria. Recumbency is favored in patients who are intact, with angular deformity less than 20°, a residual spinal canal greater than 50% of normal, and an anterior body height exceeding 50% of the posterior height. Surgical intervention is generally indicated in patients with partial neurological deficit, and those with severe instability.
Details
- Title: Subtitle
- Management Options in Thoracolumbar Burst Fractures
- Creators
- Patrick W Hitchon - Department of Surgery, Division of Neurosurgery, College of Medicine, The University of Iowa, Iowa City, Iowa, USAJames C Torner - Department of Preventive Medicine and Environmental Health, Division of Epidemiology, College of Medicine, The University of Iowa, Iowa City, Iowa, USASouheil F Haddad - Department of Surgery, Division of Neurosurgery, College of Medicine, The University of Iowa, Iowa City, Iowa, USAKenneth A Follett - Department of Surgery, Division of Neurosurgery, College of Medicine, The University of Iowa, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Surgical neurology, Vol.49(6), pp.619-627
- DOI
- 10.1016/S0090-3019(97)00527-2
- PMID
- 9637621
- NLM abbreviation
- Surg Neurol
- ISSN
- 0090-3019
- eISSN
- 1879-3339
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 1998
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9984040340402771
Metrics
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