AN ANALYSIS OF CONSERVATIVE OR SURGICAL MENAGEMENT OF THORACOLUMBAR FRACTURES

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AN ANALYSIS OF CONSERVATIVE OR SURGICAL MENAGEMENT OF THORACOLUMBAR FRACTURES

Journal Title: Journal of Turkish Spinal Surgery - Year 1991, Vol 2, Issue 3

Abstract

Betweer 1986 and 1922, 70 patients were treated for thoracolumbar fractures, 40 ofthem, who were adequate-ly followed up, were evaluated. 35 patients had majör injury; 20 of them were treated conservatı'vely and 15 were treated surgicaly. The neural status of ali consen/atively treated patients except one was Frankel E. No neurogical deterioration was seen in these patients. Various degrees of pain were present in most of the patients. The mean initial deformity kyphosis, scoliosis and loss of vertebrai body height were 13.3°, 3.3°, % 39; residual deformity ky-phosis, scoliosis and loss of vertebrai body height were 15.9°, 2.4°, % 31.7 respectively. Of the 15 patients who were treated surgically, in 8 patients Frankel E, in 2 patients Frankel D, in 3 patients Frankel C, in 2 patients Frankel A were determined. 4 patients were applied. Harrington Instrumentation (Hl + Laminectomy (L) + Posterior Fusion (PF), 2 patients were applied Hl + PF, 3 patients were Alici Spinal. Instrumentation (ASI) + L + PF were applied, 5 patients were applied ASI, and 1 patient was applied ASI + An-terior Fusion (AF) by an anterior approach. No improvement was seen in Frankel A group. 1 patient showed neu-rological deterioration while 4 patients had improvement in their neurological status. The mean kyphosis, scoliosis angles and loss of vertebrai body height were found to be 15.3°, 1.5°, % 19.2 postoperatively (inital values were 23.1°, 1.8°, % 47.5). These values were determined as 20.8°, 1.6°, % 24.3 at the most recent follow up. We suggested that either conservative or surgical treatment can be useful in thoracolumbar fractures when in-dicated properly. Betweer 1986 and 1922, 70 patients were treated for thoracolumbar fractures, 40 ofthem, who were adequate-ly followed up, were evaluated. 35 patients had majör injury; 20 of them were treated conservatı'vely and 15 were treated surgicaly. The neural status of ali consen/atively treated patients except one was Frankel E. No neurogical deterioration was seen in these patients. Various degrees of pain were present in most of the patients. The mean initial deformity kyphosis, scoliosis and loss of vertebrai body height were 13.3°, 3.3°, % 39; residual deformity ky-phosis, scoliosis and loss of vertebrai body height were 15.9°, 2.4°, % 31.7 respectively. Of the 15 patients who were treated surgically, in 8 patients Frankel E, in 2 patients Frankel D, in 3 patients Frankel C, in 2 patients Frankel A were determined. 4 patients were applied. Harrington Instrumentation (Hl + Laminectomy (L) + Posterior Fusion (PF), 2 patients were applied Hl + PF, 3 patients were Alici Spinal. Instrumentation (ASI) + L + PF were applied, 5 patients were applied ASI, and 1 patient was applied ASI + An-terior Fusion (AF) by an anterior approach. No improvement was seen in Frankel A group. 1 patient showed neu-rological deterioration while 4 patients had improvement in their neurological status. The mean kyphosis, scoliosis angles and loss of vertebrai body height were found to be 15.3°, 1.5°, % 19.2 postoperatively (inital values were 23.1°, 1.8°, % 47.5). These values were determined as 20.8°, 1.6°, % 24.3 at the most recent follow up. We suggested that either conservative or surgical treatment can be useful in thoracolumbar fractures when in-dicated properly.

Authors and Affiliations

AKBAŞ A. , ÜNSALDI T. , KUNT M. , AKBAŞ A. , ÜNSALDI T. , KUNT M.

Keywords

ANALYSIS CONSERVATIVE SURGICAL MENAGEMENT

EP ID EP676155
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