Neurologic recovery from thoracolumbar burst fractures: is it predicted by the amount of initial canal encroachment and kyphotic deformity?

被引:27
作者
Dai, Li-Yang [1 ]
Wang, Xiang-Yang [1 ]
Jiang, Lei-Sheng [1 ]
机构
[1] Shanghai Jiao Tong Univ, Sch Med, Dept Orthoped Surg, Xinhua Hosp, Shanghai 200092, Peoples R China
来源
SURGICAL NEUROLOGY | 2007年 / 67卷 / 03期
关键词
spinal fractures; thoracic vertebrae; lumbar vertebrae; spinal canal; spinal cord injuries;
D O I
10.1016/j.surneu.2006.08.068
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: The association between neurologic recovery and initial compromise of spinal canal and sagittal alignment has been rarely documented. This study was performed to better understand whether the degree of neurologic recovery from thoracolumbar burst fractures is affected and predicted by initial compromise of spinal canal and sagittal alignment. Methods: Eighty-seven patients who underwent conservative or surgical treatment for thoracolumbar burst fractures between 1993 and 2001 were prospectively followed up for 3 to 10 years (average, 5.5 years). They were assessed for neurologic deficit and improvement as defined by the scoring system of ASIA, the stenotic ratio of spinal canal and kyphosis angle. Results: The ASIA score in 52 patients with neurologic deficit averaged 34.0 (range, 0-50) on admission and 46.1 (range, 27-50) at final follow-up. All these patients except 2 with neurologic deficit experienced improvement with an average recovery rate of 72.7% (range, 0%-100%). No statistically significant difference (P >.05) in the stenotic ratio of spinal canal or kyphotic deformity was demonstrated among the patients with no neurologic deficit, with incomplete lesions, and with complete lesions. The stenotic ratio of spinal canal or kyphosis angle was not significantly correlated with initial and final ASIA score and recovery rate (P >.05). Conclusions: The neurologic recovery from thoracolumbar burst fractures is not predicted by the amount of initial canal encroachment and kyphotic deformity. When deciding on the treatment for patients with thoracolumbar burst fractures, both neurologic function and spinal stability should be taken into account. (c) 2007 Elsevier Inc. All fights reserved.
引用
收藏
页码:232 / 238
页数:7
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