[The efficacy of non-operative treatment of burst fractures of the thoracolumbar vertebrae].
OBJECTIVE
We evaluated the efficacy of non-operative treatment of thoracolumbar burst fractures.


METHODS
The study included 26 patients (19 males, 7 females; mean age 36 years; range 18 to 67 years) who underwent conservative treatment for single-level thoracolumbar fractures without posterior column involvement. None of the patients had neurologic deficits and canal encroachment was 50% or less in all fractures. Functional results were evaluated with the use of Denis' pain and work scales. Relationships were sought between functional results and follow-up time, progression in kyphosis angle, residual kyphosis, and residual canal stenosis, and between radiologic parameters.


RESULTS
Functional results were excellent or good in 65.3%, and poor in 7.7%. Three patients required surgery because of pain. Final follow-up evaluations showed a significant progression in the mean Cobb angle (p<0.001) and a significant remodelization in the mean canal encroachment (p<0.001). No significant correlations were found between progression in kyphosis, residual kyphosis, residual canal stenosis, and functional results (p>0.05). The mean initial Cobb angle was correlated with the mean initial canal encroachment (p<0.05). There was also a correlation between the initial canal encroachment and final remodelization (p<0.001).


CONCLUSIONS
Although non-operative management of thoracolumbar fractures has considerable efficacy, it may yield poor results in a small percentage of patients, some of whom require surgery because of pain. Thus, further prospective, randomized, and comparative studies with longer follow-up periods are required to define prognostic factors that may predict poor results following non-operative treatment.
Celebi
Levent
L
Department of Orthopedics and Traumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey. leventcelebi@ixir.com
Muratli
Hasan Hilmi
HH
Doğan
Ozgür
O
Yağmurlu
Mehmet Firat
MF
Aktekin
Cem Nuri
CN
Biçimoğlu
Ali
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001510:Bed Rest; D001915:Braces; D005260:Female; D017102:Fracture Healing; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome