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ISSN 1025-0255 (Electronic)

2017, Number 5

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AMC 2017; 21 (5)

Characterization of thoracolumbar fractures with neurological damage

Guedes CML, Hernández GE, Guerra PHA, Rodríguez MS

Language: Spanish
References: 30
Page: 621-630
PDF size: 659.49 Kb.


ABSTRACT

Background: the most frequent spinal fractures involve the thoracolumbar region with the 90 percent of all spinals fractures. The majority of these injuries occur between T11 to L2 levels that are weak to the stress from the biomechanical point of view.
Objective: to characterize patients with thoracolumbar spinal fractures with neurological damage.
Methods: a descriptive, retrospective and longitudinal study was conducted in 42 patients with fractures and spinal cord injuries assisted in the Orthopaedic and Traumatology service of Manuel Ascunce Domenech hospital in Camagüey from January 2000 to December 2015.
Results: in our study male sex and the 36 to 50 age group were the most frequently affected, the imaging investigations showed that between T10 and L2 was the most affected level. High falls was the most presented cause, the calcaneal fractures were the most founded associated trauma. The pulmonary thromboembolism was the most observed complication and the neurological improvement was evident in mostly all the patients.
Conclusions: the treatment to the patients with thoracolumbar spinal fractures with neurological damage is a challenge that requires team management and the surgical decompression of the neural element is the best choice.


REFERENCES

  1. 1.Byung-Guk K, Jin-Myoung D, Dong-Eun S. Treatment of Thoracolumbar Fracture. Asian Spine J [Internet]. 2015 Feb [citado 2016 Oct 14];9(1):[about 13 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330209/.

  2. 2.Rajasekaran S, Mugesh Kanna R, Prasad Shetty A. Management of thoracolumbar spine trauma: An overview. Indian J Orthop [Internet]. 2015 Jan-Feb [citado 2016 Oct 14];49(1):[about 10 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292328/.

  3. 3.Grivna M, Eid HO, Abu-Zidan FM. Epidemiology of spinal injuries in the United Arab Emirates. World J Emerg Surg [Internet]. 2015 May [citado 2016 Oct 14];10(1):[about 13 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4437450/.

  4. 4.Stahel Ph, Flierl M, Moore E, Smith W, Beauchamp K, Dwyer A. Advocating "spine damage control" as a safe and effective treatment modality for unstable thoracolumbar fractures in polytrauma patients: a hypothesis. J Trauma Manag Outcomes [Internet]. 2009 [citado 2016 Oct 14];3:[about 6 p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686673/.

  5. 5.Leferink VJ, Nijboer JM, Zimmerman KW, Veldhuis EF, ten Vergert EM, ten DH. Thoracolumbar spinal fractures: segmental range of motion after dorsal spondylodesis in 82 patients: a prospective study. Eur Spine J [Internet]. 2002 Feb [citado 2016 Oct 14];11(1):[about 5 p.]. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610492/.

  6. 6.Ya-Bo Y, Wei Q, Zi-Xiang W, Tian-Xia Q, Ee-Chon T, Wei L. Finite Element Study of the Mechanical Response in Spinal Cord during the Thoracolumbar Burst Fracture. PLoS One [Internet]. 2012 [citado 2016 Oct 14];7(9):[about e41397 p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454413/.

  7. 7.El-Faramawy A, El-Menyar A, Zarour A, Maull K, Riebe J, Kumar K, et al. Presentation and outcome of traumatic spinal fractures. J Emerg Trauma Shock [Internet]. 2012 Oct-Dec [citado 2016 Oct 14];5(4):[about 4 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519044/.

  8. 8.Nikolaus A, Kaiser T, Moulin P, Jörg K. Short-segment posterior instrumentation combined with anterior spondylodesis using an autologous rib graft in thoracolumbar burst fractures: Good outcomes in 32 patients. Acta Orthop [Internet]. 2014 Feb [citado 2016 Oct 14];85(1):[about 7 p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940997/.

  9. 9.Toyone T, Ozawa T, Wada Y, Kamikawa K, Watanabe A, Yamashita T, et al. Transpedicular hydroxyapatite grafting with indirect reduction for thoracolumbar burst fractures with neurological deficit: A prospective study. Indian J Orthop [Internet]. 2007 Oct-Dec [citado 2016 Oct 14];41(4):[about 9 p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989521/.

  10. 10.Zhigang Z, Guangdong Ch, Jiajia S, Genlin W, Huilin Y, Zongping L, Jun Z. Posterior indirect reduction and pedicle screw fixation without laminectomy for Denis type B thoracolumbar burst fractures with incomplete neurologic deficit. J Orthop Surg Res [Internet]. 2015 [citado 2016 Oct 14];10:[about 85 p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458344/.

  11. 11.Yunshan S, Dong R, Yan Z, Jian L, Pengcheng W. A retrospective study evaluating the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures. Clinics (Sao Paulo) [Internet]. 2016 Jun [citado 2016 Oct 14];71(6):[about 5 p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4930660/.

  12. 12.Jianhui D, Haibin L, Susheng N, Xianwei W, Yujun W, Huaizhi Z. Correlation of bone fragments reposition and related parameters in thoracolumbar burst fractures patients. Int J Clin Exp Med [Internet]. 2015 [citado 2016 Oct 14];8(7):[about 7 p.]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565296/.

  13. 13.Cheng-Meng G, Yu-Ren W, Sheng-Dan J, Lei-Sheng J. Thoracolumbar burst fractures with a neurological deficit treated with posterior decompression and interlaminar fusion. Eur Spine J [Internet]. 2011 Dec [citado 2016 Oct 14];20(12):[about 7 p.]. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229728/.

  14. 14.Doud AN, Weaver AA, Talton JW, Barnard RT, Meredith JW, Stitzel JD, et al. Has the Incidence of Thoracolumbar Spine Injuries Increased in the United States From 1998 to 2011? Clin Orthop Relat Res [Internet]. 2015 Jan [citado 2016 Oct 14];473(1):[about 7 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311639/.

  15. 15.Joaquim AF, Patel AA. Thoracolumbar spine trauma: Evaluation and surgical decision-making. J Craniovertebr Junction Spine [Internet]. 2013 Jan-Jun [citado 2016 Oct 14];4(1):[about 3 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872658/.

  16. 16.Xiao-Bin W, Ming Y, Jing L, Guang-Zhong X, Chang L, Guo-Hua L. Thoracolumbar fracture dislocations treated by posterior reduction, interbody fusion and segmental instrumentation. Indian J Orthop [Internet]. 2014 Nov-Dec [citado 2016 Oct 14];48(6):[about 5 p.]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872658/.

  17. 17.Muralidhar BM, Durgaprasad H, Hussain PS. Management of Unstable Thoracolumbar Spinal Fractures by Pedicle Screws and Rods Fixation. J Clin Diagn Res [Internet]. 2014 Feb [citado 2016 Oct 14];8(2):[about 3 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972526/.

  18. 18.Kumar A, Aujla R, Lee C. The management of thoracolumbar burst fractures: a prospective study between conservative management, traditional open spinal surgery and minimally interventional spinal surgery. Springerplus [Internet]. 2015 Apr [citado 14 Oct 2016];4(1):[about 3 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418977/.

  19. 19.Hegde A, Babu R, Shetty A. Management of Unstable Thoraco-Lumbar Fractures with Pedicular Screw Instrumentation: A Series of 30 cases. J Clin Diagn Res [Internet]. 2013 Nov [citado 2016 Oct 14];7(11):[about 3 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3879847/.

  20. 20.Thormann U, Erli HJ, Brügmann M, Szalay G, Schlewitz G, Pape HC, et al. Association of clinical parameters of operatively treated thoracolumbar fractures with quality of life parameters. Eur Spine J [Internet]. 2013 Oct [citado 2016 Oct 14];22(10):[about 8 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804682/.

  21. 21.Pintar FA, Yoganandan N, Maiman DJ, Scarboro M, Rudd RW. Thoracolumbar Spine Fractures in Frontal Impact Crashes. Ann Adv Automot Med [Internet]. 2012 Oct [citado 2016 Oct 14];56(1):[about 6 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503432/.

  22. 22.Zhao QM, Gu XF, Yang HL, Liu ZT. Surgical outcome of posterior fixation, including fractured vertebra, for thoracolumbar fractures. Neurosciences (Riyadh) [Internet]. 2015 Oct [citado 2016 Oct 14];20(4):[about 5 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727623/.

  23. 23.Lee HJ, Moon BJ, Pennant WA, Shin DA, Kim KN, Yoon DH, et al. Three Cases of Spine Fractures after an Airplane Crash. Korean J Neurotrauma [Internet]. 2015 Oct [citado 2016 Oct 14];11(2):[about 5 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847504/.

  24. 24.Hasler RM, Exadaktylos AK, Bouamra O, Benneker LM,Clancy M, Sieber R, et al. Epidemiology and predictors of spinal injury in adult major trauma patients: European cohort study. Eur Spine J [Internet]. 2011 Dec [citado 2016 Oct 14];20(12):[about 6 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229733/.

  25. 25.Singh R, Rohilla RK, Kamboj K, Magu NK, Kaur K. Outcome of Pedicle Screw Fixation and Monosegmental Fusion in Patients with Fresh Thoracolumbar Fractures. Asian Spine J [Internet]. 2014 Jun [citado 2016 Oct 14];8(3):[about 6 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068849/.

  26. 26.Xi-Yan X, Zheng-Jian Y, Qing M, Liang C, Zhen-Yong K, Fu C, et al. Clinical application of the paraspinal erector approach for spinal canal decompression in upper lumber burst fractures. J Orthop Surg Res [Internet]. 2014 Nov [citado 2016 Oct 14];9:[about 10 p.]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4240844/.

  27. 27.Tee JW, Chan CH, Fitzgerald MC, Liew SM, Rosenfeld JV. Epidemiological Trends of Spine Trauma: An Australian Level 1 Trauma Centre Study. Global Spine J [Internet]. 2013 Jun [citado 2016 Oct 14];3(2):[about 9 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3854579/.

  28. 28.Zhu Q, Shi F, Cai W, Bai J, Fan J, Yang H. Comparison of Anterior Versus Posterior Approach in the Treatment of Thoracolumbar Fractures: A Systematic Review. Int Surg [Internet]. 2015 Jun [citado 2016 Oct 14];100(6):[about 9 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4587517/.

  29. 29.Ghasemi AA, Ashoori S. Efficacy of Pedicle Screw Fixation in Unstable Upper and Middle Thoracic Spine Fractures. Trauma Mon [Internet]. 2016 Feb [citado 2016 Oct 14];21(1):[about e28627 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839423/.

  30. 30.Biglari B, Child C, Yildirim TM, Swing T, Reitzel T, Moghaddam A. Does surgical treatment within 4 hours after trauma have an influence on neurological remission in patients with acute spinal cord injury? Ther Clin Risk Manag [Internet]. 2016 Aug [citado 2016 Oct 14];12:[about 7 p.]. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012849




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