Journal article
Predictors of outcome in the non-operative management of thoracolumbar and lumbar burst fractures
British Journal of Neurosurgery, Vol.28(5), pp.653-657
10/01/2014
DOI: 10.3109/02688697.2013.872226
PMID: 24377725
Abstract
Aim. Burst fractures without neurological deficit are often treated successfully without surgery. A subgroup may fail non-operative treatment owing to pain, and opt for surgery.The following review was conducted to identify predictors of success or failure in the non-operative treatment of thoracolumbar burst fractures. Methods. A cohort of 60 patients with T11-L4 thoracolumbar burst fractures were treated non-operatively, with bed rest and bracing until the pain abated sufficiently to allow mobilization. Patients were followed prospectively for a mean ± SD of 12 ± 14 months, and their data were reviewed retrospectively. Results. Fifty-one patients successfully completed non-operative treatment. Owing to intractable pain in nine, surgery was undertaken. Ages in the non-operative and operative groups were 46 ± 18 and 68 ± 15 years respectively (p = 0.002). The residual canal and angulation at the site of the fracture were 63 ± 12% and 1.6 ± 8.4° in the non-operative group and 47 ± 15% and 6.6 ± 13.6° in the surgical group (p = 0.001 and 0.149 between groups, respectively). Regression analysis of age, gender, angulation, and residual canal showed that only age (OR, 1.099; 95% CI, 1.022-1.183; p = 0.011) and residual canal (OR, 0.795; 95% CI, 0.642-0.985; p = 0.035) were significant predictors of failure, ultimately undergoing surgery. Conclusion. Non-surgical treatment was more likely to prove sufficient in patients aged 46 ± 18 years, and residual canal of 63 ± 12%, than in older patients with ages of 68 ± 15, and canal of 47 ± 15%. The latter group was more likely to fail, undergoing surgery because of pain or instability.
Details
- Title: Subtitle
- Predictors of outcome in the non-operative management of thoracolumbar and lumbar burst fractures
- Creators
- Patrick W Hitchon - Department of Neurosurgery, University of IowaWenzhuan He - Department of Neurology, New Jersey Medical SchoolStephen Viljoen - Department of Neurosurgery, University of IowaNader S Dahdaleh - Department of Neurological Surgery, Northwestern UniversityRajinder Kumar - Department of Neurosurgery, All India Institute of Medical SciencesJennifer Noeller - Department of Neurosurgery, University of IowaJames Torner - Department of Epidemiology, University of Iowa
- Resource Type
- Journal article
- Publication Details
- British Journal of Neurosurgery, Vol.28(5), pp.653-657
- DOI
- 10.3109/02688697.2013.872226
- PMID
- 24377725
- NLM abbreviation
- Br J Neurosurg
- ISSN
- 0268-8697
- eISSN
- 1360-046X
- Publisher
- Taylor & Francis
- Language
- English
- Date published
- 10/01/2014
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983995015002771
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