Pavlos Panteliadis1, Omar Musbahi2,3, Senthil Muthian4, Shivam Goyal3, Alexander Sheriff Montgomery4, Arun Ranganathan4. 1. Department of Trauma and Orthopedics, Guy's Hospital, Guy's and St Thomas NHS Trust, London, England. 2. Oxford University Clinical Academic Graduate School, Oxford University, Oxford, England. 3. Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, England. 4. Spinal Department, Royal London Hospital, Whitechapel Rd, London, England.
Abstract
INTRODUCTION: Management of thoracolumbar fractures remains controversial in the literature. The primary aims of this study were to assess different levels of fixation with respect to radiological outcomes in terms of fracture reduction and future loss of correction. METHODS: This is a single center, retrospective study. Fifty-five patients presenting with thoracolumbar fractures between January 2012 and December 2015 were analyzed in the study. The levels of fixation were divided in 3 groups, 1 vertebra above and 1 below the fracture (1/1), 2 above and 2 below (2/2), and 2 above and 1 below (2/1). RESULTS: The most common mechanism was high fall injury and the most common vertebra L1. Burst fractures were the ones with the highest incidence. The 2/2 fixation achieved the best reduction of the fracture but with no statistical significance. The correction is maintained better by the 2/2 fixation but there is no statistical difference compared to the other fixations. Insertion of screws at the fracture level did not improve outcomes. CONCLUSION: The data of this study identified a trend towards better radiological outcomes for fracture reduction and maintenance of the correction in the 2/2 fixations. However these results are not statistically significant. Future multicenter prospective clinical trials are needed in order to agree on the ideal management and method of fixation for thoracolumbar fractures.
INTRODUCTION: Management of thoracolumbar fractures remains controversial in the literature. The primary aims of this study were to assess different levels of fixation with respect to radiological outcomes in terms of fracture reduction and future loss of correction. METHODS: This is a single center, retrospective study. Fifty-five patients presenting with thoracolumbar fractures between January 2012 and December 2015 were analyzed in the study. The levels of fixation were divided in 3 groups, 1 vertebra above and 1 below the fracture (1/1), 2 above and 2 below (2/2), and 2 above and 1 below (2/1). RESULTS: The most common mechanism was high fall injury and the most common vertebra L1. Burst fractures were the ones with the highest incidence. The 2/2 fixation achieved the best reduction of the fracture but with no statistical significance. The correction is maintained better by the 2/2 fixation but there is no statistical difference compared to the other fixations. Insertion of screws at the fracture level did not improve outcomes. CONCLUSION: The data of this study identified a trend towards better radiological outcomes for fracture reduction and maintenance of the correction in the 2/2 fixations. However these results are not statistically significant. Future multicenter prospective clinical trials are needed in order to agree on the ideal management and method of fixation for thoracolumbar fractures.
Authors: Robert P Norton; Edward L Milne; David N Kaimrajh; Frank J Eismont; Loren L Latta; Seth K Williams Journal: Spine J Date: 2014-01-23 Impact factor: 4.166
Authors: Alexander R Vaccaro; Cumhur Oner; Christopher K Kepler; Marcel Dvorak; Klaus Schnake; Carlo Bellabarba; Max Reinhold; Bizhan Aarabi; Frank Kandziora; Jens Chapman; Rajasekaran Shanmuganathan; Michael Fehlings; Luiz Vialle Journal: Spine (Phila Pa 1976) Date: 2013-11-01 Impact factor: 3.468