Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

This review aims to search the epidemiology and incidence rates of thoracolumbar spine fractures. A systematic review of the literature of the last 10 years gave 586 results with “incidence,” and 387 results with “epidemiology,” of which 39 papers were analyzed. The review results were discussed and voted in 2 consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee. Out of 39 studies, 15 studies have focused on thoracolumbar trauma, remaining 24 studies have looked at all spine trauma. Most were retrospective in nature; few were prospective and multicenter. Some studies have focused on specific injuries. The annual incidence of TL fractures is about 30/100,000 inhabitants including osteoporotic fractures. There is a trend to increase the fractures in elderly population especially in developed countries, while an increase of motor vehicle accidents in developing countries. The mortality rate among male elderly patients is relatively high. The incidence of thoracolumbar spine fractures is increasing because of low-velocity falls in the elderly population. The main reasons are falls and traffic accidents. Learning the regional differences and some special forms of trauma such as extreme sports, war, and gunshot injuries will help the prevention of the thoracolumbar spine fractures.

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Classification and Radiological Diagnosis of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Neurospine ◽

10.14245/ns.2142650.325 ◽

2021 ◽

Vol 18 (4) ◽

pp. 656-666

Author(s):

Abdul Hafid Bajamal ◽

Khrisna Rangga Permana ◽

Muhammad Faris ◽

Mehmet Zileli ◽

Nikolay A. Peev

Keyword(s):

Literature Review ◽

Text Analysis ◽

Thoracolumbar Spine ◽

Radiological Diagnosis ◽

Management Decision ◽

World Federation ◽

Spine Fractures ◽

Radiologic Diagnosis ◽

Management Decision Making ◽

Thoracolumbar Spine Fractures

The aim of this review to determine recommendations for classification and radiological diagnosis of thoracolumbar spine fractures. Recommendation was made through a literature review of the last 10 years. The statements created by the authors were discussed and voted on during 2 consensus meetings organized by the WFNS (World Federation Neurosurgical Societies) Spine Committee. The literature review was yielded 256 abstracts, of which 32 were chosen for full-text analysis. Thirteen papers evaluated the reliability of a classification system by our expert members and were also chosen in this guideline analysis. This literature review-based recommendation provides the classification and radiologic diagnosis in thoracolumbar spine fractures that can elucidate the management decision-making in clinical practice.

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Kyphosis After Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Neurospine ◽

10.14245/ns.2142340.170 ◽

2021 ◽

Vol 18 (4) ◽

pp. 681-692

Author(s):

Onur Yaman ◽

Mehmet Zileli ◽

Salim Şentürk ◽

Kemal Paksoy ◽

Salman Sharif

Keyword(s):

English Language ◽

Case Reports ◽

Thoracolumbar Spine ◽

Case Series ◽

Osteoporotic Fractures ◽

World Federation ◽

Posterior Surgery ◽

Posttraumatic Kyphosis ◽

Time Treatment ◽

Thoracolumbar Spine Fractures

Thoracolumbar fractures change the biomechanics of the spine. Load distribution causes kyphosis by the time. Treatment of posttraumatic kyphosis is still controversial. We reviewed the literature between 2010 and 2020 using a search with keywords “thoracolumbar fracture and kyphosis.” We removed osteoporotic fractures, ankylosing spondylitis fractures, non-English language papers, case reports, and low-quality case series. Up-to-date information on posttraumatic kyphosis management was reviewed to reach an agreement in a consensus meeting of the World Federation of Neurosurgical Societies (WFNS) Spine Committee. The first meeting was conducted in Peshawar in December 2019 with WFNS Spine Committee members’ presence and participation. The second meeting was a virtual meeting via the internet on June 12, 2020. We utilized the Delphi method to administer the questionnaire to preserve a high degree of validity. We summarized 42 papers on posttraumatic kyphosis. Surgical treatment of thoracolumbar kyphosis due to unstable burst fractures can be done via a posterior only approach. Less blood loss and reduced surgery time are the main advantages of posterior surgery. Kyphosis angle for surgical decision and fusion levels are controversial. However, global sagittal balance should be taken into consideration for the segment that has to be included. Adding an intermediate screw at the fractured level strengthens the construct.

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