Nonoperative treatment in burst fractures of the lumbar spine (L2-L5) without neurologic deficits.
A retrospective review of 20 patients treated nonoperatively for burst fractures of the lumbar spine (L2-L5) was performed. All patients were neurologically intact at the time of injury. Follow-up averaged 3.9 years with a range of 2.1 to 9.1 years. Fourteen patients were men and six were women. The average age at injury was 35.8 years (8-67 years). Sixty-five percent of the injuries were the result of motor vehicle accidents and 35% falls from height. Fifty-five percent were two-column injuries and 45% three-column injuries. Kyphotic deformity averaged 8 at injury (-7 to 30) and 9.6 at follow-up (-8 to 33). Computed tomography scans were performed in nine patients during evaluation of injury. Spinal canal compromise averaged 40% (18-75%). Eighteen patients (90%) were considered to have a good to excellent functional outcome, whereas two patients had a fair outcome. No patient had a poor outcome. In no patient did neurologic deterioration or symptomatic spinal stenosis develop. Twenty-five percent of patients had no back pain, 70% mild back pain, and 5% moderate back pain. No patient was totally incapacitated by pain. Of those employed, all returned to full-time work. Nonoperative treatment should be considered as an alternative in the treatment of lumbar burst fractures (L2-L5) in patients presenting without initial neurologic deficits.
Chan
D P
DP
Department of Orthopaedics, School of Medicine and Dentistry, University of Rochester, New York.
Seng
N K
NK
Kaan
K T
KT
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D009420:Nervous System / Q000503:physiopathology; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed