Long Term Follow-up of the Stable Fractures Around Thoracolumbar Spinal Junction (Conservative Management vs. Operative Intervention).
- Author:
Jae Sung AHN
;
June Kyu LEE
;
Seung Jin LEE
- Publication Type:Original Article
- MeSH:
Accidents, Traffic;
Dislocations;
Follow-Up Studies*;
Fractures, Compression;
Osteoporosis;
Prognosis;
Retrospective Studies;
Spinal Fractures;
Spine;
Vertebrates
- From:Journal of Korean Society of Spine Surgery
1997;4(2):249-256
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: The treatment of a stable fracture around thoracolumbarjunction is a controversial subject. OBJECTIVES: To evaluate the result from long term follow-up of the stable spinal fracture around thoracolumbar junction according to the operation, osteoporosis and in situ extension bar, respectively. SUMMARY OF BACKGROUND DATA: The thoracolumbar junction is a transitional zone in which the kyphotic angle of thoracic spine is continued to the lordotic angle of lumbar splne. So it is prone to be injured biomechanically, and the stability of the spine around thoracolumbar junction is not determined yet. METHODS: We studied retrospectively 105 cases of the stable fracture around thoracolumbar junction from January 1985 to December 1995. The criteria of the stability were a compression fracture by Denis F., a bursting fracture without involvement of posterior column, a neural enchroachment of bony fragment below 30%, fracture without subluxation or dislocation in spinal junction. RESULTS: The most common cause was traffic accident and, the first lumbar vertebrate was common site. Below 30% of initial compression, the progression was not exceded 5% in operative group. But in nonoperative group, anterior compression was more progressed than initial compression over 5%. The degree of anterior compression was affected by osteoporosis and in situ extension bar just after injury. CONCLUSIONS: We suggest an anterior compression abode 30% in spinal body of thoracolumbar junction for an additional operative indication. The prognosis may be affected by osteoporosis and in situ extension bar.
