We conclude the device is a useful, reliable tool for measuring sagittal spinal ROM in clinical practice, considering the small load it confers on patients and the short amount of time the measurement involves. The SpinalMouse might be more accurate after following the recommendations we make.

This study was conducted to study the functional outcome after non-operative treatment of type A thoracolumbar spinal fractures without neurological deficit. Functional outcome was determined following the International Classification of Functioning, Disability and Health, measuring restrictions in body function and structure, restrictions in activities, and restrictions in participation/quality of life. All patients were treated non-operatively for a type A thoracolumbar (Th11-L4) spinal fracture at the University Hospital Groningen, The Netherlands. Thirty-three of the eighty-one selected patients agreed to participate in the study (response-rate 41%). Respondents were older than non-respondents (mean 50.5 years vs. 39.2 years), but did not differ from each other concerning injury-related variables. Patients with a neurological deficit were excluded. Treatment consisted either of mobilisation without brace, or of bedrest followed by wearing a brace. Restrictions in body function and structure were measured by physical tests (dynamic lifting test and bicycle ergometry test); restrictions in activities were measured by means of questionnaires, the Roland Morris Disability Questionnaire (RMDQ) and Visual Analogue Scale Spine Score (VAS). Restrictions in participation/quality of life were assessed with the Short Form 36 (SF-36) and by means of return to work status. Thirty-seven per cent of the patients were not able to perform the dynamic lifting test within normal range. In the ergometry test, 40.9% of the patients performed below the lowest normal value, 36.4% of the patients achieved a high VO(2)-max. Mean RMDQ-score was 5.2, the mean VAS-score was 79. No significant differences between patients and healthy subjects were found in SF-36 scores, neither were differences found between braced and unbraced patients in any of the outcome measures. Concerning the return to work status, 10% of the subjects had stopped working and received social security benefits, 24% had arranged changes in their work and 14% had changed their job. We conclude that patients do reasonably well 5 years after non-operative treatment of a thoracolumbar fracture, although outcome is diverse in the different categories and physical functioning seems restricted in a considerable number of patients.

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Literature regarding the effect of a spinal fracture and its treatment in terms of resulting spinal range of motion (ROM) is scarce. However, there is need for data regarding sagittal spinal ROM, since many patients who sustain a spinal fracture are concerned about the back mobility they will have after treatment. In addition, the relationship between ROM and impairment is not clear. The literature gives conflicting results. To study spinal ROM after a spinal fracture, we measured thoracolumbar ROM in operatively and non-operatively treated patients (n=76, average 3.7 years follow-up) as well as controls (n=41). In order to study the relation between ROM and subjective back complaints, we calculated the correlation between thoracolumbar ROM and scores derived from the VAS spine score and RMDQ. To assess impairment after a spinal fracture, we compared RMDQ and VAS scores between operatively and non-operatively treated patients and healthy controls. Operatively treated patients were found to have lower thoracolumbar ROM than controls (56.7 degrees vs 70.0 degrees , respectively; p<0.01). There was no difference between operatively treated and non-operatively treated patients (56.7 degrees vs 62.7 degrees , respectively); nor was a difference found between non-operatively treated patients and controls. Correlation between ROM and subjective impairment was very weak and only significant for ROM and RMDQ scores in the whole study group (rho= -0.25; p<0.01). Patients were more impaired than controls, there was no difference between operatively and non-operatively treated patients (VAS score 76.3 vs 72.6; RMDQ score 4.5 vs 4.4, respectively). We conclude that patients treated operatively for a thoracolumbar spinal fracture have a lower thoracolumbar ROM than controls. Spinal ROM, however, does not influence impairment. A spinal fracture results in impairment, no matter what therapy is chosen.