title: Surgery in vertebral fracture: epidemiology and functional and radiological results in a prospective series of 518 patients at 1 year's follow-up.
abstract: BACKGROUND
  Recent epidemiological data for spinal trauma in France are sparse. However, increased knowledge of sagittal balance and the development of minimally invasive techniques have greatly improved surgical management.
  
  
  OBJECTIVE
  To describe the epidemiology and management of traumatic vertebral fracture, and to analyze evolution and risk factors for poor functional outcome at 1 year's follow-up.
  
  
  METHODS
  A prospective multicenter French cohort study was performed over a 6-month period in 2011, including all cases of vertebral fracture surgery. Data were collected by online questionnaire over the Internet. Demographic characteristics, lesion type and surgical procedures were collected. Clinical, functional and radiological assessment was carried out at 1 year.
  
  
  RESULTS
  Five hundred and eighteen patients, with a mean age of 47 years, were included. Sixty-seven percent of fractures involved the thoracic or lumbar segment. Thirty percent of patients had multiple fractures and 28% neurological impairment. A minimally invasive technique was performed in 20% of cases and neurological decompression in 25%. Dural tear was observed in 42 patients (8%). Seventy percent of patients were followed up at 1 year. Functionally, SF-36 scores decreased on all dimensions, significantly associated with age, persistent neurological deficit and previous spine imbalance. Thirty-eight percent of working patients had returned to work. Radiologically, sagittal balance was good in 74% of cases, with fracture consolidation in 70%.
  
  
  CONCLUSIONS
  Despite progress in management, spinal trauma was still a source of significant morbidity in 2011, with pronounced decrease in quality of life. Conserved sagittal balance appeared to be associated with better functional outcome.
authors.affiliation: Département de chirurgie orthopédique et de traumatologie du sport, hôpital Pitié-Salpêtrière, AP-HP Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Bouyer
authors.affiliation: Département de neurochirurgie, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34090 Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Vassal
authors.affiliation: Département de neurochirurgie, hôpital universitaire de Lille, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Zairi
authors.affiliation: Unité rachidienne, département de chirurgie orthopédique, hôpital universitaire de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Dhenin
authors.affiliation: Département de neurochirurgie, hôpital universitaire de Dijon, 7, rue Isabelle-de-Portugal, 21000 Dijon, France.
authors.forename: M
authors.initials: M
authors.lastname: Grelat
authors.affiliation: Unité rachidienne et tumorale, département de chirurgie orthopédique, hôpital universitaire Bicêtre, AP-HP Paris, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
authors.forename: A
authors.initials: A
authors.lastname: Dubory
authors.affiliation: Unité rachidienne, département de chirurgie orthopédique, hôpital La Conception, AP-HM Marseille, université Aix-Marseille, 147, boulevard Baille, 13005 Marseille, France.
authors.forename: H
authors.initials: H
authors.lastname: Giorgi
authors.affiliation: Service de chirurgie du Rachis Pavillon chirurgical B, hôpitaux universitaires de Strasbourg, BP 426, 67091 Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Walter
authors.affiliation: Département de chirurgie orthopédique, hôpital Raymond-Poincaré, université Versailles Saint-Quentin, AP-HP Paris, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors.forename: G
authors.initials: G
authors.lastname: Lonjon
authors.affiliation: Département de chirurgie orthopédique, hôpital Beaujon, université Paris Diderot, AP-HP Paris, 100, boulevard Général-Leclerc, 92110 Clichy, France.
authors.forename: C
authors.initials: C
authors.lastname: Dauzac
authors.affiliation: Département de neurochirurgie, hôpital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34090 Montpellier, France. Electronic address: nlonjon@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Lonjon
mesh_terms: D000367:Age Factors; D019299:Decompression, Surgical; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D062707:Return to Work / Q000706:statistics & numerical data; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*
keywords: Cohort study; Outcome; Quality of life; Spinal fracture