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. 2. Oxford University Clinical Academic Graduate School, Oxford. 3. Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London. 4. Spinal Department, Royal London Hospital, London.
Abstract
BACKGROUND: 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 toward 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.
BACKGROUND: 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 toward 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: George Sapkas; Konstantinos Kateros; Stamatios A Papadakis; Emmanouel Brilakis; George Macheras; Pavlos Katonis Journal: Open Orthop J Date: 2010-01-15
Authors: Stefanie Fitschen-Oestern; Florian Scheuerlein; Matthias Weuster; Tim Klueter; Leif Menzdorf; Deike Varoga; Christoph Kopetsch; Michael Mueller; Alex van der Horst; Andreas Seekamp; Peter Behrendt; Sebastian Lippross Journal: Injury Date: 2015-10 Impact factor: 2.586