Thoracic spine fractures: injury profile and outcomes of a surgically treated cohort

Abstract

There are only few reports in literature about the treatment of traumatic lesions of the thoracic spine. They have been grouped together with thoracolumbar fractures, ignoring the particular biomechanics of the thoracic segment. The objective of this retrospective cohort is to describe the clinical presentation and outcomes of surgically treated patients with these injuries. Data were obtained from the institutional database of medical registries, identifying all the patients who had been treated for thoracic spine fractures, from January 1, 1995 through December 31, 2005 in our institution. The study group included the 51 surgically treated patients. General and surgery-related complications were considered as clinical outcomes and injury-related disability was also assessed. Statistical analysis evaluating possible associations with timing and type of surgery, neurological impairment and associated injuries was carried out. Motor vehicle accident was the most frequent mechanism of injury. Six patients had an incomplete neurological deficit, whereas 22 had a complete lesion. Thirty-two patients presented at least one complication. Five of the neurologically intact patients, while 20 of those with neurological impairment presented general complications (p = 0.0001). None of the patients' neurological status deteriorated after surgery. All patients with complete spinal cord injury and those with incomplete cord injury with partial functional recovery received disability compensation. Short pedicle instrumentations should be used whenever possible, but also long instrumentations and mixed constructs may be necessary for the management of such unique fractures.

Neurological outcome in a series of 58 patients operated for traumatic thoracolumbar spinal cord injuries

“…[3] In our series of thoracolumbar SCIs, 72.4% of patients neurologically improved one or more ASIA level after surgery compared with the neurological status at admission. According to literature, this improvement suggests that an early surgical decompression of spinal cord (<24 h since trauma) and posterior stabilization maximize the opportunity of neurological recovery.…”

Dorso-Lumbar Burst Fractures Secondary to a Peculiar Tipper Truck Injury: A Report on Two Cases

“…From Russia it has been reported that 33% of all accidents occurred during gymnastics. [1][2][3][4][5][6] As per report of the International Conference (Spinal Injuries Management, New Delhi, 1995), the incidence of spinal injury was estimated at 15 new cases per million per year in India. This translates into 15,000 new cases per year, and with a backlog of 10 years, the prevalence exceeds 0.15 million.…”

“…Minimal encroachment of spinal canal at this level may produce severe deficits. 1,2 We introduce two new peculiar cases of dorsolumbar burst fractures secondary to a peculiar tipper truck injury to the literature.…”

Biomechanics and clinical outcome after posterior stabilization of mid-thoracic vertebral body fractures: a systematic literature review

“…After surgical treatment of thoracic vertebral fractures by posterior stabilization in general, non-surgery-related complications occur in 49%-60%, especially in patients with complete or incomplete paraplegia [28,46]. Deep venous thrombosis is observed in 4%-9% [13,36]-compared to 24.5% in conservatively treated patients [5].…”