Early mobilization of patients with unstable fractures of the thoracic and lumbar spine. A 2-year follow-up study.
During the acute immobilization period 18 patients, with unstable fractures of the spine together with, in most cases, a spinal cord lesion, caudally of T2, were tilted in bed or on a tilting table. Twelve of these patients began the tilting already in the second week after the injury and reached +30 degrees on the 15th day, +50 degrees on the 37th day and +90 degrees on the 65th day following the injury. All patients were kept under observation at regular intervals up to 2 years. A comparison between similar patient groups, treated strictly conservatively, and the present patient groups did not show any differences either in respect to deformities in the spinal column, expected reduction in the spreading of the spinal cord lesions or in the subjective symptoms of the patients. In the hope of reducing the complications induced by protracted immobilization, the authors recommend that patients with unstable fractures of the spinal column, caudally of T2, with or without spinal cord lesion, begin a specified tilting program already in the second week following the injury.
D000293:Adolescent; D000328:Adult; D004434:Early Ambulation; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011187:Posture; D011859:Radiography; D013119:Spinal Cord Injuries / Q000150:complications; D013124:Spinal Injuries / Q000150:complications / Q000534:rehabilitation / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D013997:Time Factors