The management of thoracic and thoraco-lumbar injuries of the spine with neurological involvement.
The results of treatment of injuries of the thoracic and thoraco-lumbar spine with neurological involvement have been reviewed in a retrospective study of 115 patients, of whom eighty-nine received conservative and twenty-six surgical treatment. Operation was reserved, in general, for patients with irreducible dislocations and incomplete neurological lesions, open reduction and internal fixation being the commonest procedure. Only three patients required a delayed spinal fusion for suspected instability after a period of conservative treatment. On the other hand, ten patients, eight of whom had been treated surgically, were left with severe chronic spinal pain. Of the patients treated conservatively, 35% showed significant neurological improvement compared to 38% of those treated surgically, but the latter group contained a much higher proportion of incomplete lesions with a far better prognosis. It is concluded that the place for early operation might be still further restricted.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000628:therapy; D006801:Humans; D007223:Infant; D004204:Joint Dislocations / Q000628:therapy; D007796:Laminectomy; D008161:Lumbosacral Region / Q000293:injuries*; D008875:Middle Aged; D011379:Prognosis; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000628:therapy; D013123:Spinal Fusion; D013124:Spinal Injuries / Q000628:therapy*; D013898:Thoracic Injuries / Q000628:therapy*; D013997:Time Factors