The epidemiology of thoracolumbar trauma: A meta-analysis

Katsuura, Yoshihiro; Osborn, James; Cason, Garrick W.

doi:10.1016/j.jor.2016.06.019

Cited by 110 publications

(100 citation statements)

References 38 publications

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“…9 In general, the epidemiology of our patient sample was similar to that of majority of trauma series found in the literature, as most of our patients were male adults with thoracolumbar junction fractures. [10][11][12] Additionally, none of our patients had late neurological deficits, suggesting that conservative treatment of type A fractures is safe when considering neurological preservation, as demonstrated in prior studies. [13][14][15] However, while neurologically safe and effective, the mean ODI of our series was 24.39%, suggesting that type A fractures can lead to some degree of long-term disability even when surgical treatment is not required.…”

Section: Discussionmentioning

confidence: 53%

Is There an Association With Spino-Pelvic Relationships and Clinical Outcome of Type A Thoracic and Lumbar Fractures Treated Non-Surgically?

et al. 2018

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Background: The objective was to evaluate if there is an association of the spino-pelvic relationships and the global spinal alignment with the outcome of AO type A injuries treated nonsurgically. Methods: This is a retrospective case series. Patients treated nonsurgically for AOSpine type A fractures (T1-L5) with at least 1 year follow-up identified. A standing antero-posterior and lateral 36-inch radiographs and measures of spino-pelvic relationships and sagittal alignment were obtained, as well as clinical assessment using the visual analog scale, the Short-Form 36 (SF-36) questionnaire, the Oswestry Disability Index (ODI), and labor status. Results: Twenty-two patients with 33 fractures were included (L1 was the most injured level with 18.2%). There were 17 men (77.2%) and the mean age was 47.1 years. Follow-up ranged from 12 to 60 months (mean of 27.8 months). There were 22 type A1 (66.7%), 3 type A2 (9%), 6 type A3 (18%), and 2 type A4 (6%) fractures. The ODI ranged from 4% to 58%, with a mean of 24.4%. The SF-36 physical health score ranged from 23 to 82.25 (mean 49.59), and the mental health score ranged from 14.75 to 94.25 (mean 63.28). No association was identified between the spino-pelvic measurements, global alignment, and patient-reported outcomes. Conclusions: Type A fractures had a clinically relevant amount of long-term disability even when surgical treatment is not required. Spino-pelvic relationships and final global spinal alignment did not associate with outcome measurements.

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Section: Discussionmentioning

confidence: 53%

Is There an Association With Spino-Pelvic Relationships and Clinical Outcome of Type A Thoracic and Lumbar Fractures Treated Non-Surgically?

et al. 2018

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“…Verletzungen im Bereich der thorakolumbalen Wirbelsäule sind häufig mit einem Thoraxtrauma vergesellschaftet [16]. Deshalb kann auch die neurologische Untersuchung (D-Disability) noch Hinweise auf ein bis dahin übersehenes Thoraxtrauma geben.…”

Section: Merkeunclassified

Der Patient mit Thoraxtrauma: präklinische Versorgung

Hansen¹,

Hachenberg²

2017

Anästhesiol Intensivmed Notfallmed Schmerzther

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Penetrating thoracic injuries are rare in Germany and common in urban regions. 10 percent of the patients in Emergency Departments suffer from blunt thoracic trauma. Mechanism of trauma can predict the severity of the injuries. Very fast life-threatening injuries with hemodynamic problems like tension pneumothorax or cardiac tamponade have to be diagnosed. Prehospital emergency physicians need skills in ultrasound for diagnosis and in invasive therapy like chest tube or pericardium drainage tube. The application of an algorithm in exploration of a thoracic trauma seems to be useful. The selection of trauma center depends on the severity of the trauma, if necessary with the availability of extracorporeal circulation.

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“…Spinal fractures are usually the result of a highenergy trauma. The thoracolumbar junction (T11-L2) is biomechanically prone to injury as it marks the transition from the rigid thoracic spine to the flexible lumbar spine [2].…”

Section: Introductionmentioning

confidence: 99%

“…The most common mechanism incriminated for (SCI) is represented by motor vehicle accidents (36.7% of fractures), followed by falls from height (which accounted for 31.7%) [1], [2]. In an american level 1 trauma center, the rate of injury to the thoracolumbar spine was 6.9% [2]. Burst fractures are the ones with the highest incidence [3], [4].…”

Section: Introductionmentioning

confidence: 99%

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From “cage to independence”: good outcomes of an unstable (burst) lumbar fracture, surgically managed with an expandable titanium vertebral cage implant, with posterior transpedicular instrumentation, and rehabilitation program – case presentation

Anghelescu¹,

Cimpeanu²,

Bajenaru³

et al. 2018

Balneo

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Introduction: The thoracolumbar junction (T11-L2) is biomechanically prone to spinal cord injuries (SCI), as it marks the transition from the rigid thoracic segment to the flexible lumbar spine. The damage of the spinal cord is due to a high-energy trauma (mainly motor vehicle accidents, falls from height, etc), in most cases resulting burst fractures of the lumbar region. The vertebral body is crushed in all directions, retro pulsed bony fragments are spread out towards the spinal canal, damaging the spinal cord, and causing neurologic injuries. Case report: This is a retrospective case study of a slim 43-year-old woman who suffered on 23.06.2018 a polytrauma (accidental fall from 3m height, from tree), associating thoraco-abdominal contusions, without cranial trauma and a severe L1 vertebral comminuted / burst fracture, followed by flaccid T12 AIS-A (complete) paraplegia. She underwent a complex neurosurgical approach, with a self-expandable metallic cage (Stryker) and posterior transpedicular stabilization for decompression and circumferential fusion in one stage, without cavity involvement. In an early post-acute stage she was admitted to the Rehabilitation Clinic (from 10.07.2018 until 31.08.2018) as a T12 AIS-C paraplegia (incomplete neurological lesion, with a global motor score 59/100; lower legs motor score 9/50 [4/25 R+5/25 L], with neurogenic bowel and bladder. The evolution was favorable and she was discharged as L2 AIS-D paraplegia (global motor score 70/100; lower legs motor score 20/50 [10/25 R+10/25 L]. Discussion: This case report emphasizes the benefits and functional outcomes after a comprehensive therapeutic approach, of a patient with unstable (burst) lumbar fracture, surgically managed with an expandable titanium vertebral cage implant with posterior transpedicular instrumentation, followed by a complex rehabilitation program, Stryker distractible vertebral body replacement implant is an expandable device, which can adapt to the patient`s anatomy, enabling the neurosurgeons to treat severe burst fractures. Rehabilitation objectives were focused on B-ADL independence (activity, component of the ICF-DH framework)-transfers, orthostatic posture, restore walking, bladder control. The vital prognosis and functional outcome were favorable. Although she was able to use a walking frame at discharge, there were a few drawbacks in what concerns the professional reintegration, due to specific external barriers (she was a military personnel, had neither driving licensee, nor an adapted car). Conclusions: This clinical case underlines the importance of a complex and multidisciplinary approach, prompt surgical intervention and rehabilitation during the early post-acute phase.

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The epidemiology of thoracolumbar trauma: A meta-analysis

Abstract: Here we report the incidence of thoracolumbar fracture in blunt trauma and the spectrum of associated injuries. To our knowledge, this paper provides the first epidemiological road map for blunt trauma thoracolumbar injuries.

Cited by 110 publications

References 38 publications

Is There an Association With Spino-Pelvic Relationships and Clinical Outcome of Type A Thoracic and Lumbar Fractures Treated Non-Surgically?

Is There an Association With Spino-Pelvic Relationships and Clinical Outcome of Type A Thoracic and Lumbar Fractures Treated Non-Surgically?

Der Patient mit Thoraxtrauma: präklinische Versorgung

From “cage to independence”: good outcomes of an unstable (burst) lumbar fracture, surgically managed with an expandable titanium vertebral cage implant, with posterior transpedicular instrumentation, and rehabilitation program – case presentation

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