A modeling capacity of vertebral fractures exists during growth: an up-to-47-year follow-up.
METHODS
The study is an observational cohort study.


OBJECTIVE
To determine the incidence and the long-term outcome of thoracic or lumbar vertebral fractures in children.


BACKGROUND
The incidence of vertebral fractures in children is described as rare and the outcome as favorable. However, no studies evaluate the clinical and radiographic long-term outcome and if a fractured vertebra could be rebuilt during growth.


METHODS
The incidence of vertebral fractures in children was evaluated through the radiographic archives. Twelve boys and 12 girls, aged 7-16 when sustaining the fracture, 21 one-column compression fractures and 3 burst fractures Denis type B, all without neurologic deficits, attended the follow-up. Primary treatment consisted of immediate mobilization without brace. Clinical and radiographic examinations were performed 27-47 years after the injury.


RESULTS
The annual incidence of thoracic and lumbar vertebral body fractures in individuals below age 16 was 0.07%. Twenty-one individuals had, at follow-up, no subjective complaints, 3 had occasional back pain (Oswestry Scores 8, 22, and 26), 23 were classified as Frankel E, and 1 as Frankel D. The radiographic ratio anterior height/posterior height of the fractured vertebral body increased from 0.75 after injury to 0.87 at follow-up (P < 0.001). The posttraumatic kyphosis in the fractured region decreased in 8 individuals (33%), all aged 13 or less at fracture. No increased disc degeneration was observed.


CONCLUSIONS
Thoracolumbar vertebral fractures without neurologic deficits, sustained during growth, have a favorable long-term outcome. A modeling capacity, reducing the fracture deformity, exists at least in the youngest patients.
D000293:Adolescent; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000502:physiology*; D050815:Fractures, Compression / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D007738:Kyphosis / Q000453:epidemiology / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D011859:Radiography; D020127:Recovery of Function; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome