A thoracic and lumbar spine injury severity classification based on neurologic function grade, spinal canal deformity, and spinal biomechanical stability

ABSTRACT Objective: To evaluate the correlation between structural changes in burst fractures of thoracic and lumbar spine with clinical outcome of the treatment. Methods: A retrospective study in 25 patients with fractures of thoracic and lumbar spine burst fractures without neurological deficit. Eleven patients underwent conservative treatment and for the remaining the treatment was surgical. All patients were followed up for at least 24 months. The cases were evaluated by a protocol that included: posttraumatic measurement of kyphosis, vertebral body collapse and narrowing of the spinal canal, the visual analog scale of pain, and the quality of life questionnaire SF-36 at the follow-up. For statistical analysis, the significance level was 5% and the software SPSS 18.0 was used. Results: No statistically significant difference was observed when comparing the clinical outcomes of one treatment over another. Similarly, there was no statistically significant correlation between kyphosis and post-traumatic narrowing of the spinal canal with clinical worsening in the follow-up, regardless of the treatment used. We found a positive correlation (p<0.05) between initial collapse and SF-36 domains in both groups (operated and non-operated). Conclusion: There was no significant superiority of one treatment over the other, and no correlation was found between kyphosis and spinal canal narrowing in burst fractures of the thoracic and lumbar spine without neurological deficit. However, there was correlation between initial collapse and clinical outcome in some domains of the SF-36 questionnaire.

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TRANSPEDICULAR FIXATION FOR THORACIC AND LUMBAR SPINE INJURY WITH POST-TRAUMATIC SPINAL STENOSIS

Hirurgiâ pozvonočnika ◽

10.14531/ss2011.4.8-17 ◽

2011 ◽

pp. 8-17 ◽

Cited By ~ 1

Author(s):

Asker Afaunov ◽

◽

Aleksandr Kuzmenko ◽

Keyword(s):

Lumbar Spine ◽

Spinal Stenosis ◽

Spine Injury ◽

Transpedicular Fixation ◽

Thoracic And Lumbar Spine ◽

Post Traumatic

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Curiosity or underdiagnosed? Thoracolumbar spinal column injuries with concomitant trauma of the pancreas

10.21203/rs.3.rs-66190/v1 ◽

2020 ◽

Author(s):

Jakob Hax ◽

Sascha Halvachizadeh ◽

Kai Oliver Jensen ◽

Till Berk ◽

Henrik Teuber ◽

...

Keyword(s):

Lumbar Spine ◽

Injury Severity Score ◽

Severity Score ◽

Injury Severity ◽

Spinal Injury ◽

Thoracolumbar Spine ◽

Pancreatic Injury ◽

Spinal Injuries ◽

Spine Injury ◽

The Mean

Abstract Background: The pancreas is an organ which is at risk of damage as a consequence of thoracolumbar spine injury. However, to our knowledge, no studies have provided any prevalence data to support this assumption. Therefore, the coincidence of pancreatic trauma in patients with spine injury is still unknown. Data from the TraumaRegister DGU® (TR-DGU) was analysed to estimate the prevalence of this correlation and to determine its influence on clinical outcome.Methods: A retrospective investigation of cases documented in the TR-DGU between 2008 and 2017 was performed. We included data of patients admitted to participating European trauma centres who had thoracic or lumbar spine injuries and met the following criteria: i) Injury Severity Score (ISS) ≥ 9, ii) blunt trauma, and iii) no early transfer out of hospital. We investigated the coincidence of pancreas injury in patients with at least an Abbreviated Injury Scale (AIS) of 2 of the thoracic or lumbar spine. Therefore, we included all kind of relevant injuries of the thoracolumbar spine.Results: In the group with thoracolumbar injury with concomitant pancreatic injury, the mean age was 43.1 ± 18.6 years, and 68% of these patients were male. The most frequent mechanisms of trauma were car (38%) and motorbike (17%) accidents, as well as high falls (23.8%). The mean Injury Severity Score was 35.7 ± 16.0 points and the in-hospital mortality rate was 17.5%. The overall prevalence of pancreatic injury was 60.7 (0.61%; 95% confidence interval (CI), 0.58–0.65) per 10,000 patients. Patients with severe spinal injuries (AIS ≥ 2) were more likely to present with a concomitant pancreatic injury compared to patients with no or only minor spinal injury (AIS 0–1) (Odds ratio (OR) 1.78; 95%CI, 1.57–2.01).Conclusions: Concomitant pancreatic injury in patients with spinal injuries of the thoracolumbar spine is rare. However, patients with more severe spinal injuries were overall more likely (OR 1.78) to present with an accompanying pancreatic injury than those with minor thoracolumbar injuries. Therefore, trauma surgeons treating severely injured patients must be alert not to overlook this rare concomitant injury, because it does not clearly correlate with the severity of spinal injury.

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AO spine injury classification system: a revision proposal for the thoracic and lumbar spine

European Spine Journal ◽

10.1007/s00586-013-2738-0 ◽

2013 ◽

Vol 22 (10) ◽

pp. 2184-2201 ◽

Cited By ~ 82

Author(s):

Maximilian Reinhold ◽

Laurent Audigé ◽

Klaus John Schnake ◽

Carlo Bellabarba ◽

Li-Yang Dai ◽

...

Keyword(s):

Lumbar Spine ◽

Classification System ◽

Spine Injury ◽

System A ◽

Thoracic And Lumbar Spine ◽

Injury Classification

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Analysis of the spinal canal dimensions and neurological symptoms dynamics in surgical treatment of burst fractures of the thoracic and lumbar spine

Ukrainian Neurosurgical Journal ◽

10.25305/unj.127792 ◽

2018 ◽

Vol 0 (2) ◽

pp. 47-60

Author(s):

Vladimir A. Radchenko ◽

Konstantin A. Popsuyshapka ◽

Sergii A. Teslenko

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Spinal Canal ◽

Neurological Symptoms ◽

Burst Fractures ◽

Thoracic And Lumbar Spine

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Surgical Treatment of Complicated Spine Injury in Acute Period

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto200310348-52 ◽

2003 ◽

Vol 10 (3) ◽

pp. 48-52 ◽

Cited By ~ 1

Author(s):

A G Aganesov ◽

K T Meskhi ◽

A P Nikolaev ◽

E P Kostiv ◽

A G Aganesov ◽

...

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Preoperative Planning ◽

Plate Fixation ◽

Spine Injury ◽

Optimum Time ◽

Decompressive Laminectomy ◽

Cervical Spine Injuries ◽

Spine Injuries ◽

Thoracic And Lumbar Spine

Analysis of surgical treatment of 193 patients with complicated injury of cervical, thoracic and lumbar spine was performed. Optimum time for surgery, approaches, operation stages as well as necessity of injured segments fixation are considered. In cervical spine injuries decompression, spondylodesis with autobone and CSLP (AO) plate fixation were performed. In thoracic and lumbar spine injuries decompressive laminectomy, revision, meningomyeloradiculosis when indicated, suturing of injured radicis with following transpedicular fixation using USS (AO) system were carried out. High efficacy of surgical treatment for complicated spine injuries is proved in availability of minimum time after injury, rational preoperative planning, adequate anesthesiology provision, wide decompression, and accurate choice of implanted metal device.

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Posterolateral decompression, distractive reduction and reconstructive stabilization for the treatment of thoracic and lumbar spine fracture-dislocations

10.21203/rs.3.rs-18702/v1 ◽

2020 ◽

Author(s):

Changbao Chen ◽

Xiaolin Zhang ◽

Xinlong Ma

Keyword(s):

Lumbar Spine ◽

Demographic Data ◽

Spine Fracture ◽

Preoperative Pain ◽

Radiographic Outcomes ◽

Thoracic And Lumbar Spine ◽

Fracture Dislocations ◽

Neurologic Function ◽

The Ideal

Abstract Background: Fracture-dislocations of the thoracic and lumbar spine are uncommon and highly unstable injuries, and the ideal management for patients with thoracic and lumbar spine fracture-dislocations is challenging. This study was designed to evaluate the clinical and radiographic results following posterolateral decompression, distractive reduction and reconstructive stabilization for patients with severe thoracic and lumbar spine fracture-dislocations.Methods: Twenty-three patients with thoracic and lumbar spine fracture-dislocations underwent this procedure. Demographic data, radiographic results, neurologic function, clinical functions and treatment-related complications were prospectively evaluated. Results: The average preoperative sagittal and coronal displacement was 31.9% and 6.7%, significantly improved to 6.4% and 2.1% after surgery, respectively. The final sagittal and coronal displacement was 5.3% and 1.5%. The average segmental kyphosis was 20.4° before surgery, markedly corrected to 4.7° immediately after surgery. The final sagittal kyphosis was 6.1°. Twelve patients with incomplete neurologic deficits had improvement by at least one ASIA grade neurologic improvement. The preoperative pain level showed a mean VAS score of 9.5 improved to 3.5 postoperatively, and to 1.2 at the final follow-up. Mean ODI preoperatively was 90.2%, and improved to 38.3% postoperatively, and to 24.9% at the final follow-up. No patient had persistent postoperative back pain. No obvious complications were observed in this series.Conclusions: Posterolateral decompression, distractive reduction and reconstructive stabilization is a reasonably safe and effective technique for thoracic and lumbar spine fracture-dislocations. This replicable procedure can result in satisfactory clinical and radiographic outcomes, with sufficiently circumferential decompression, excellent reduction, perfect spine alignment, solid instrumentation and sound fusion.

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Lumbar Spine Injury in the Athlete

Clinics in Sports Medicine ◽

10.1016/s0278-5919(20)30740-7 ◽

1990 ◽

Vol 9 (2) ◽

pp. 419-448 ◽

Cited By ~ 1

Author(s):

Robert G. Watkins ◽

William H. Dillin

Keyword(s):

Lumbar Spine ◽

Spine Injury

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