[Thoracolumbar fractures].
Thoracolumbar fractures are frequent and the functional outcomes are sometimes severe. This multicentric study, including five medical centers, was performed to evaluate the long-term outcomes of the patients. One hundred and thirty six patients with thoracolumbar fracture (T11 to L2) was evaluated with a minimal follow-up of two years. Every one had a clinical exam with a score of Oswestry and an X-Ray study (before and after treatment and at revision). Most of them presented compression fractures, the most often at L1 level. On X-rays, a gain was noted on the vertebral kyphosis immediately after surgery, but there is a loss of correction over time whatever the treatment. The clinical outcomes for the patients were great, with an Oswestry average score of 6,4. A correlation was noted between this functional score and vertebral kyphosis. So, an anterior column strengthening (isolated or performed during the surgery) could improve these functional outcomes. Moreover, the Thoraco Lumbar Injury Severity Score (TLISS) seems to be a simple organigram to determine the most appropriate treatment of these fractures, with particular attention to the distraction mechanism or posterior ligamentous complex lesions. However, RMI before surgery is necessary to evaluate these lesions.
Service de chirurgie orthopédique et traumatologique, CHU de la Milétrie, 2, rue de la Milétrie, 86000 Poitiers, France. m.freslon@chu-poitiers.fr
M
M
Freslon
D
D
Bouaka
P
P
Coipeau
G
G
Defossez
N
N
Leclercq
J
J
Nebout
E
E
Marteau
N
N
Poilbout
R
R
Prebet
D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016103:Spinal Fractures / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome