Stabilization of thoracic spine fractures resulting in complete paraplegia. A long-term retrospective analysis.
METHODS
The impact of surgical stabilization on initial rehabilitation and complications in patients with traumatic thoracic level paraplegia was investigated. One hundred thirteen patient records were retrospectively reviewed.


BACKGROUND
Forty-six patients had been treated with surgical stabilization and fusion. Nineteen patients had been treated by laminectomy alone. Forty-eight patients had been treated nonoperatively. The most common mechanism of injury was a motor vehicle accident (52.6%). The mean follow-up was 8.4 years.


METHODS
All inpatient and outpatient records at Craig Hospital were reviewed for patients who had sustained a thoracic spine fracture (T2-T9) that resulted in complete paraplegia (Frankel A). All patients were followed for a minimum of 5 years. Data were collected regarding initial length of inpatient rehabilitation, as well as early and late complications that affected rehabilitation and function during follow-up. This information was analyzed by treatment group.


RESULTS
There was a statistically significant difference in the length of initial rehabilitation days between the surgically stabilized group and the laminectomy-only group. There was a trend toward fewer in-patient rehabilitation days between the surgically stabilized group and the nonoperatively treated group. The surgically treated group had twice as many complications as the nonoperative group.


CONCLUSIONS
The surgical stabilization of thoracic (T2-T9) spine fractures with complete paraplegia tends to decrease initial rehabilitation days but is associated with increased overall complications. The treatment of this patient group clearly must be individualized.
Place
H M
HM
Orthopaedic Service, Fitzsimons Army Medical Center, Aurora, Colorado.
Donaldson
D H
DH
Brown
C W
CW
Stringer
E A
EA
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008297:Male; D010264:Paraplegia / Q000453:epidemiology / Q000209:etiology* / Q000534:rehabilitation; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000293:injuries*; D013997:Time Factors