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.

No abstract

The clinical records, operation records, X-rays and CT-scans of 160 operatively treated patients with A-type and B-type spinal fractures were evaluated in a retrospective study. The preoperative diagnosis was compared with the postoperative diagnosis. Analysis of characteristics of patients with A-type fractures (without the unrecognised B-type fractures), initially unrecognised B-type (uB) fractures, and B-type fractures (without the unrecognised B-type fractures) was performed. We analysed the age of the patients, the respective fracture levels, neurologic deficit, anterior wedge angles (AWA), anterior corporal height (ACH), posterior corporal height (PCH), and the percentage of frontal corporal collapse (FCC). The t-test was used for statistical analysis. The mean age of patients in each group did not show a significant difference. The group of unrecognised B-fractures had a more caudal fracture level than the recognised B-type fractures. The fracture levels of the A-group and the uB-group patients showed no difference using the t-test. The percentage of patients with spinal fractures with neurologic deficit is 16% in the A-type fracture group, 12% in the uB-fracture group and 50% in the B-type group. The preoperative classification of patients in the A-group and in the uB-group showed that patients in the uB-group have more than proportional relatively simple preoperative A-fractures. The AWA and ACH did not show significant differences between the groups. The mean PCH of the uB-group was higher than the PCH of the A-group. No differences were measured between the uB-group and the B-group. The mean percentages of frontal corporal collapse (FCC) did not show a significant difference. Thirty percent of B-type fractures are misdiagnosed when plain X-rays and CT scans with 2D reconstructions are used as the only preoperative diagnostic tools. A large PCH with a normal interspinous distance should raise the suspicion of a B-type lesion. A large AWA does not point to a ligamentary B-type fracture.

The aim of the study was to develop an insight into the impairments in spinal fracture patients, operatively treated with an internal fixator, and also into their ability to participate in daily living, return to work and quality of life as defined by the World Health Organization. Nineteen patients operated for a type A fracture of the thoracolumbar spine (T9-L4) between 1993 and 1998 in the University Hospital Groningen, the Netherlands, aged between 18 and 60 years, without neurological deficit were included in the study. Operative treatment consisted of fracture reduction and internal fixation using the Universal Spine System, combined with transpedicular cancellous bone grafting and dorsal spondylodesis. No ventral fusion operations, laminectomies or discectomies were done. Restrictions in body function and structure were measured on radiographs and in functional capacity tests, such as lifting tests and ergometry. Restrictions in activities were studied with the Visual Analogue Scale (VAS) Spine Score and the Roland Morris Disability Questionnaire (RMDQ). Restrictions in participation/quality of life were analysed with the Short Form 36 (SF36) and described in the return to work status. The radiological results are comparable to the literature. The reduction of the anterior wedge angle was followed by a gradual partial loss of intervertebral angle ORIGINAL ARTICLE Eur Spine J (2003) 12 : 261-267

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.