Evaluation of Functional and Radiographic Outcomes of Thoracolumbar Fractures (original) (raw)
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(ii) Thoracolumbar spinal fractures: review of anatomy, biomechanics, classification and treatment
Orthopaedics and Trauma, 2014
The management of thoracolumbar spine fractures remains a controversial issue. There is disagreement both as to how to describe these injuries and how to manage them. No ideal classification system, accepted by the world of spinal surgery, exists and such systems are under on-going development. While the majority of these injuries can be managed conservatively, new surgical techniques have been developed alongside the evolution of diagnostic tools classification systems.
Neurospine
To obtain a list of recommendations about clinical and radiological factors affecting outcome in thoraco-lumbar fractures with the aim of helping spine surgeons in daily practice. A systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020 on the topic “thoracolumbar fracture AND radiology AND surgical outcomes” and “thoracolumbar fracture AND radiology AND surgical outcomes.” A total of 58 papers were analyzed and WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meetings to formulate the specific recommendations the first in Peshawar in December 2019 and in a subsequent virtual meeting in June 2020 to reach an agreement. Both meetings utilized the Delphi method to analyze preliminary literature review statements based on the current evidence levels to generate recommendations through a comprehensive voting session. Eight statements were presented and reached the consensus about this topic. A variety of clin...
European Journal of Orthopaedic Surgery and Traumatology, 2006
This year’s ARGOS International Symposium, held in Paris, January 26–27, focused on thoracolumbar fractures and their assessment.Indeed this topic is of high interest for spine surgeons around the world as the treatment of thoracolumbar is still a matter of debate. As in every year, over 250 attendees gathered at the Salons d’Iéna eager to exchange their ideas and different points of view in the well-established friendly and collegial atmosphere of ARGOS meetings. Together with the faculty members, who covered most of the issues related to this particularly hot topic, they tried to better understand thoracolumbar fractures mechanisms and define therapeutic patterns.Thursday January 26Session 1Starting the first session on Thursday afternoon, Professor Jean-Paul Steib, MD, Strasbourg, France, and Doctor Mark Weidenbaum, MD, New York, USA, discussed the “Choice of approach—Posterior, anterior, double approach—decision criteria”.The indications for surgery when dealing with thoracolumbar
Spine, 2015
Web-based-multicenter study OBJECTIVE.: To assess and compare the management strategy for traumatic thoracolumbar fractures between German and Dutch spine surgeons. To date, there is no evidence-based treatment algorithm for thoracolumbar spine fractures. Thereby an international controversy concerning optimal treatment exists. In this web-based-multicenter study (www.spine.hostei.com) CT-scans of traumatic thoracolumbar fractures (T12-L2) were evaluated by German and Dutch spine surgeons. Supplementary case-specific information as age, gender, height, weight, neurological status, and injury mechanism were provided.By use of a questionnaire, fractures were classified according to the AO-Magerl Classification, followed by six questions concerning the treatment algorithm. Data were analyzed using SPSS (Version 21, 76 Chicago IL, USA). The interobserver agreement was determined by Cohens-Kappa. Statistical significance was defined as p < 0.05. Twelve surgeons (six/country) evaluated...
Introduction to Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations
Neurospine, 2021
World Federation of Neurosurgical Societies (WFNS) Spine Committee is focused on giving a new horizon in light of research and available recent past data. With the increasing advances and day to day variations in surgical approaches, it has become extremely important to develop new guidelines and recommendations. After developing and publishing guidelines about cervical trauma, 1 spinal cord injury, 2 lumbar spinal stenosis, 3 and cervical spondylotic myelopathy, 4 the WFNS Spine Committee has developed recommendations regarding thoracolumbar (TL) spine trauma. This was achieved after a gross literature search between 2010 and 2020 and then holding a consensus meeting. It is an honour for me to be part of this work done during the chairmanship of Prof Zileli, Prof Fornari, and myself. Up-to-date information was reviewed to reach an agreement in the World Federation of Neurosurgical Societies (WFNS) Spine Committee meeting. The first meeting was conducted live in Peshawar in December 2019, and the second meeting was a virtual meeting on June 12, 2020. Both meetings aimed to analyze a preformulated questionnaire through preliminary literature review statements based on the current evidence levels to generate recommendations through a comprehensive voting session. Delphi method was utilized to administer the questionnaire to preserve a high degree of validity. The consensus was achieved when the sum for disagreement or agreement was ≥ 66%. Each consensus point was clearly defined, with evidence strength, recommendation grade, and consensus level provided. The 6 papers you will find in the following pages are guidelines for almost all aspects of the TL fracture. The annual incidence of TL fractures is about 30/100,000 inhabitants, including osteoporotic fractures. There is a trend towards increasing fractures in developed countries, especially due to low velocity falls in the elderly population. The mortality rate after the spinal injury decreases in developed countries due to improvements in motor vehicle safety and traffic regulations. 5 The TL spine is the most frequently injured spinal region in blunt trauma. The potential risk of concomitant injury to the spinal cord, chronic pain, and lifelong disability presents a significant burden on patients and the health service. Due to the range of injury classification systems and varied treatment efficacy, literature on the indications for nonoperative treatment of TL fractures is conflicting. The WFNS Spine Committee was able to formulate numerous key recommendations to guide clinical practice. Although compression-type fractures and stable burst fractures can
Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations
Neurospine, 2021
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 inci...
Neurospine, 2021
Thoracolumbar spine is the most injured spinal region in blunt trauma. Literature on the indications for nonoperative treatment of thoracolumbar fractures is conflicting. The purpose of this systematic review is to clarify the indications for nonsurgical treatment of thoracolumbar fractures. We conducted a systematic literature search between 2010 to 2020 on PubMed/MEDLINE, and Cochrane Central. Up-to-date literature on the indications for nonoperative treatment of thoracolumbar fractures was reviewed to reach an agreement in a consensus meeting of WFNS (World Federation of Neurosurgical Societies) Spine Committee. The statements were voted and reached a positive or negative consensus using the Delphi method. For all of the questions discussed, the literature search yielded 1,264 studies, from which 54 articles were selected for full-text review. Nine studies (4 trials, and 5 retrospective) evaluating 759 participants with thoracolumbar fractures who underwent nonoperative/surgery w...
Clinical profile of thoracolumbar spine fracture in adult
International Journal of Orthopaedics Sciences, 2016
Most common site of injury was L1 vertebra. There was an increase in incidence of spinal cord injuries during summer and rainy season. All those cases of unstable dorsolumbar fractures were included in the study that fulfilled following criteria. In our series, most common type was wedge compression fractures, accounting for 56% of the cases. Next common type is burst fracture 44%.In percutaneous pedicle screw fixation group, wedge compression fracture 64% were operated, compared to 48% of conventional pedicle fixation group. Burst fractures, which constituted 36% was the in percutaneous pedicle fixation group compared to 52% of conventional pedicle fixation group. Most common type was wedge compression fracture.