Butler J S, Walsh A, O'Byrne J
National Spinal Injuries Unit, Department of Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
Int Orthop. 2005 Feb;29(1):51-4. doi: 10.1007/s00264-004-0602-x. Epub 2004 Nov 5.
We retrospectively reviewed 31 neurologically intact patients with burst L1 fractures. We obtained a follow-up clinical evaluation after a mean of 43 (14-80) months from 26 patients--11 treated surgically and 15 managed non-surgically. Patients were assessed with regard to pain, employment status, recreational activities and overall satisfaction. At final follow-up of 15 patients managed non-surgically, six had little or no pain; 12 had returned to work with six declaring little or no restrictions, and eight had returned to the same level of recreational activity as prior to injury with seven declaring little or no restrictions. Of 11 patients treated surgically, four had little or no pain; seven had returned to work with three declaring little or no restrictions, three had returned to the same level of recreational activity as prior to injury and four declared little or no restrictions. There was no correlation found between vertebral collapse, kyphosis, retropulsion and clinical outcome. Patients who had non-operative management reported a good functional outcome. However, patients who required surgical stabilisation due to different fracture characteristics reported a poorer functional outcome.
我们回顾性分析了31例L1爆裂骨折且神经功能完好的患者。我们对26例患者进行了平均43（14 - 80）个月的随访临床评估，其中11例接受手术治疗，15例采用非手术治疗。对患者的疼痛、就业状况、娱乐活动和总体满意度进行了评估。在对15例采用非手术治疗的患者进行最终随访时，6例几乎没有疼痛；12例已恢复工作，其中6例表示几乎没有限制，8例已恢复到受伤前的娱乐活动水平，其中7例表示几乎没有限制。在11例接受手术治疗的患者中，4例几乎没有疼痛；7例已恢复工作，其中3例表示几乎没有限制，3例已恢复到受伤前的娱乐活动水平，4例表示几乎没有限制。未发现椎体塌陷、后凸畸形、椎体后缘骨折块向后移位与临床结果之间存在相关性。接受非手术治疗的患者报告功能结果良好。然而，由于不同骨折特征而需要手术稳定的患者报告功能结果较差。
