Research Article
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Retrospective Evaluation of Patients Operated in Our Clinic for Thoracolumbar Fracture

Year 2023, , 100 - 104, 27.04.2023
https://doi.org/10.35440/hutfd.1263204

Abstract

Objective: Most traumatic vertebral fractures occur in the thoracolumbar junction ,lumbar spine, less frequently in the middle thoracic and upper thoracic spine. The aim of this study was to evaluate the retrospective multifactorial evaluation of cases who underwent vertebral stabilization after acute traumatic thoracolumbar fractures.

Metot: Between 2020-2022, 60 patients who underwent vertebral stabilization after acute traumatic thoracolumbar fractures were evaluated postoperatively. Each patient Clinical data, type and location of fracture, presence of neurological damage, pre- and postoperative radiological measurements, postoperative complications, reoperation, AO Spine and ASIA classification data were evaluated.

Results: The mean age of the patients was 33.5+16.2. When the trauma etiology of the patients was examined, falling was the most common with 68.3%, AITC and suicide were the second most common with 13.3%, and ATC was observed with 3.3%. Considering the localization, trauma L1 fracture was observed in 20 patients. Type B fractures were seen in 28 patients. While no complications were observed in 53 patients, revision surgery was performed in 5 patients. It was observed that the postoperative neurological examination of the patient with preoperative ASIA A did not change.

Conclusion Thoracolonbar fractures usually occur after high-energy trauma. It is frequently seen in the thoracolumbar junction and causes neurological deficits. Neurological recovery is limited in patients with complete deficits. However, neurological improvement can be observed in incomplete fractures. Treatment of patients should be started immediately and they should be allowed to return to their routine life.

References

  • 1. Muratore M, Allasia S, Viglierchio P, Abbate M, Aleotti S, Masse A, et al. Surgical treatment of traumatic thoracolumbar frac-tures: a retrospective review of 101 cases. Musculoskelet Surg. 2021;105(1):49-59.
  • 2. Zileli M, Sharif S, Fornari M. Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Rec-ommendations. Neurospine. 2021;18(4):704-12.
  • 3. Bajamal AH, Permana KR, Faris M, Zileli M, Peev NA. Classifica-tion and Radiological Diagnosis of Thoracolumbar Spine Frac-tures: WFNS Spine Committee Recommendations. Neurospine. 2021;18(4):656-66.
  • 4. Rosenthal BD, Boody BS, Jenkins TJ, Hsu WK, Patel AA, Savage JW. Thoracolumbar Burst Fractures. Clin Spine Surg. 2018;31(4):143-51.
  • 5. Koban O, Dalbayrak S. Treatment of Posttraumatic Deformities of Thoracolumbar Region: Definition - Indications for Surgical Treatment - Methods and Selection. Türk Nöroşir Derg 2020;30(3):438-46.
  • 6. Ituarte F, Wiegers NW, Ruppar T, Goldstein C, Nourbakhsh A. Posterior Thoracolumbar Instrumented Fusion for Burst Frac-tures. Clinical spine surgery. 2019;32(2):57-63.
  • 7. Todeschi J, Ganau M, Zaed I, Bozzi MT, Mallereau CH, Gallinaro P, et al. Managing Incomplete and Complete Thoracolumbar Burst Fractures (AO Spine A3 and A4). Results from a Prospec-tive Single-Center Study Comparing Posterior Percutaneous In-strumentation plus Mini-Open Anterolateral Fusion versus Sin-gle-Stage Posterior Instrumented Fusion. World Neurosurg. 2021;150:e657-e67.
  • 8. Katsuura Y, Osborn JM, Cason GW. The epidemiology of thora-columbar trauma: A meta-analysis. J Orthop. 2016;13(4):383-8.
  • 9. Doud AN, Weaver AA, Talton JW, Barnard RT, Meredith JW, Stitzel JD, et al. Has the incidence of thoracolumbar spine inju-ries increased in the United States from 1998 to 2011? Clin Or-thop Relat Res. 2015;473(1):297-304.
  • 10. Aras EL, Bunger C, Hansen ES, Sogaard R. Cost-Effectiveness of Surgical Versus Conservative Treatment for Thoracolumbar Burst Fractures. Spine (Phila Pa 1976). 2016;41(4):337-43.
  • 11. Ertürer E, Tezer M, Oztürk I, Kuzgun U. Evaluation of vertebral fractures and associated injuries in adults. Acta Orthop Trau-matol Turc. 2005;39:387-90.
  • 12. Reinhold M, Audige L, Schnake KJ, Bellabarba C, Dai LY, Oner FC. AO spine injury classification system: a revision proposal for the thoracic and lumbar spine. Eur Spine J. 2013;22(10):2184-201.
  • 13. La Rosa G, Conti A, Cardali S, Cacciola F, Tomasello F. Does early decompression improve neurological outcome of spinal cord in-jured patients? Appraisal of the literature using a meta-analytical approach. Spinal Cord. 2004;42(9):503-12.
  • 14. Cengiz SL, Kalkan E, Bayir A, Ilik K, Basefer A. Timing of thoraco-lomber spine stabilization in trauma patients; impact on neuro-logical outcome and clinical course. A real prospective (rct) ran-domized controlled study. Arch Orthop Trauma Surg. 2008;128(9):959-66.

Torakolomber Fraktür Nedeniyle Kliniğimizde Opere Edilen Hastaların Retrospektif Olarak Değerlendirilmesi

Year 2023, , 100 - 104, 27.04.2023
https://doi.org/10.35440/hutfd.1263204

Abstract

Amaç: Travmatik vertebral kırıkların çoğu torakolomber bileşkede ,lomber omurgada , daha az sıklıkla orta torasik ve üst torasik omurgada meydana gelir. Bu çalışma ile akut travmatik torakolomber kırıklardan sonra vertebral stabilizasyon yapılan vakaların retrospektif multifaktöriyel değerlendirilmesi amaçlanmıştır.

Materyal ve Metot: 2020-2022 yılları arasında, akut travmatik torakolomber kırıklardan sonra vertebral stabilizasyon yapılan 60 hasta, postop retrospektif olarak ele alındı. Her hastanın klinik verileri, kırığın tipi ve yeri, nörolojik hasarın varlığı, cerrahi öncesi ve sonrası radyolojik ölçümleri, postop komplikasyonları, reoperasyon, AO Spine ve ASIA sınıflamala verileri değerlendirildi.

Bulgular:Hastların yaş ortalaması 33,5+16,2 idi. Hastaların travma etiyolojisine bakıldığında, en sık olarak %68,3 ile düşme, ikinci sırada %13.3 ile AİTK ve intihar, %3.3 ile de ADTK gözlemlenmiştir. Lokalizasyona bakıldığında 20 hastada travma L1kırığı gözlendi. 28 hastada tip B kırığı görüldü. 53 hastada herhangi bir komplikasyon görülmezken 5 hastaya revizyon cerrahisi yapıldı. Preoperatif ASIA A olan hastanın postoperatif nörolojik muayenesinin değişmediği görüldü.

SonuçTorakolonber kırıklar genelikle yüksek enerjili travmadan sonra meydana gelir. Sıklıkla torakolomber bileşkede görülür ve nörolojik defistlerle yol açar. Komplet defisit olan hastalarda nörolojik iyileşme sınırlı olmaktadır. Ancak inkomplet kırıklarda nörolojik düzelme gözlenebilmektedir. Hastaların ivedilikle tedavisine başlanmalı ve rutin hayatına dönmesi sağlanmalıdır.

References

  • 1. Muratore M, Allasia S, Viglierchio P, Abbate M, Aleotti S, Masse A, et al. Surgical treatment of traumatic thoracolumbar frac-tures: a retrospective review of 101 cases. Musculoskelet Surg. 2021;105(1):49-59.
  • 2. Zileli M, Sharif S, Fornari M. Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Rec-ommendations. Neurospine. 2021;18(4):704-12.
  • 3. Bajamal AH, Permana KR, Faris M, Zileli M, Peev NA. Classifica-tion and Radiological Diagnosis of Thoracolumbar Spine Frac-tures: WFNS Spine Committee Recommendations. Neurospine. 2021;18(4):656-66.
  • 4. Rosenthal BD, Boody BS, Jenkins TJ, Hsu WK, Patel AA, Savage JW. Thoracolumbar Burst Fractures. Clin Spine Surg. 2018;31(4):143-51.
  • 5. Koban O, Dalbayrak S. Treatment of Posttraumatic Deformities of Thoracolumbar Region: Definition - Indications for Surgical Treatment - Methods and Selection. Türk Nöroşir Derg 2020;30(3):438-46.
  • 6. Ituarte F, Wiegers NW, Ruppar T, Goldstein C, Nourbakhsh A. Posterior Thoracolumbar Instrumented Fusion for Burst Frac-tures. Clinical spine surgery. 2019;32(2):57-63.
  • 7. Todeschi J, Ganau M, Zaed I, Bozzi MT, Mallereau CH, Gallinaro P, et al. Managing Incomplete and Complete Thoracolumbar Burst Fractures (AO Spine A3 and A4). Results from a Prospec-tive Single-Center Study Comparing Posterior Percutaneous In-strumentation plus Mini-Open Anterolateral Fusion versus Sin-gle-Stage Posterior Instrumented Fusion. World Neurosurg. 2021;150:e657-e67.
  • 8. Katsuura Y, Osborn JM, Cason GW. The epidemiology of thora-columbar trauma: A meta-analysis. J Orthop. 2016;13(4):383-8.
  • 9. Doud AN, Weaver AA, Talton JW, Barnard RT, Meredith JW, Stitzel JD, et al. Has the incidence of thoracolumbar spine inju-ries increased in the United States from 1998 to 2011? Clin Or-thop Relat Res. 2015;473(1):297-304.
  • 10. Aras EL, Bunger C, Hansen ES, Sogaard R. Cost-Effectiveness of Surgical Versus Conservative Treatment for Thoracolumbar Burst Fractures. Spine (Phila Pa 1976). 2016;41(4):337-43.
  • 11. Ertürer E, Tezer M, Oztürk I, Kuzgun U. Evaluation of vertebral fractures and associated injuries in adults. Acta Orthop Trau-matol Turc. 2005;39:387-90.
  • 12. Reinhold M, Audige L, Schnake KJ, Bellabarba C, Dai LY, Oner FC. AO spine injury classification system: a revision proposal for the thoracic and lumbar spine. Eur Spine J. 2013;22(10):2184-201.
  • 13. La Rosa G, Conti A, Cardali S, Cacciola F, Tomasello F. Does early decompression improve neurological outcome of spinal cord in-jured patients? Appraisal of the literature using a meta-analytical approach. Spinal Cord. 2004;42(9):503-12.
  • 14. Cengiz SL, Kalkan E, Bayir A, Ilik K, Basefer A. Timing of thoraco-lomber spine stabilization in trauma patients; impact on neuro-logical outcome and clinical course. A real prospective (rct) ran-domized controlled study. Arch Orthop Trauma Surg. 2008;128(9):959-66.
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Barış Erdogan 0000-0003-4946-0748

Duygu Ceman 0000-0003-0215-4233

Early Pub Date April 27, 2023
Publication Date April 27, 2023
Submission Date March 10, 2023
Acceptance Date March 27, 2023
Published in Issue Year 2023

Cite

Vancouver Erdogan B, Ceman D. Torakolomber Fraktür Nedeniyle Kliniğimizde Opere Edilen Hastaların Retrospektif Olarak Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(1):100-4.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty