Bagga Rajdeep Singh, Goregaonkar Arvind B, Dahapute Aditya Anand, Muni Saurabh R, Gokhale Sandeep, Manghwani Jitesh
Department of Orthopaedics, Seth G.S. Medical College and Kem Hospital, Parel, Mumbai, Maharashtra, India.
Department of Orthopaedics, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India.
J Craniovertebr Junction Spine. 2017 Oct-Dec;8(4):369-373. doi: 10.4103/jcvjs.JCVJS_93_17.
To study the functional and radiological outcomes in cases managed conservatively for single-level traumatic thoracolumbar spine fractures without neurological deficit.
In this prospective study design, thirty patients who presented to tertiary care hospital and diagnosed with posttraumatic thoracolumbar vertebral fracture without any neurodeficit were recruited. All the patients were managed conservatively as per the protocol which included bed rest, spinal braces, and physiotherapy. Adequate analgesia was given wherever necessary. The patients were followed at regular intervals up to a maximum of 2 years. Clinically visual analog scale (VAS) score and Roland Morris Disability Questionnaire (RMDQ)-24 were assessed and radiologically local vertebral kyphosis, scoliosis, and loss of body height were noted at each follow-up.
The data was statistically analyzed and the results were as follows. Thoracolumbar fractures were more in young adults (<26 years) and more so among the males (80% cases). The most common fracture type in our study was compression fracture. The most common site involved in our study was L1 vertebra (36.7%). There was a significant decrease of VAS score (pain score) in 79% cases with the maximum decrease in type A1 fracture. The mean RMDQ-4 score in our study was 5.53. The overall progression of kyphosis was 1.9°. There was no relation found between the kyphotic deformity and the clinical outcomes (VAS and RMDQ-24 scores). Canal size changes were found to be insignificant at the end of 2 years compared to baseline.
Study showed favorable outcomes in terms of return to daily activities, making it a good option in managing Type A1 dorsolumbar fractures. Though there was a progression of kyphosis but no neurological deficit was seen.
研究单节段无神经功能缺损的创伤性胸腰椎骨折保守治疗的功能和影像学结果。
在这项前瞻性研究设计中，招募了30名到三级医院就诊并被诊断为创伤后胸腰椎椎体骨折且无任何神经功能缺损的患者。所有患者均按照方案进行保守治疗，包括卧床休息、佩戴脊柱支具和物理治疗。必要时给予充分的镇痛。对患者进行定期随访，最长随访2年。每次随访时评估临床视觉模拟量表（VAS）评分和罗兰·莫里斯残疾问卷（RMDQ）-24，并记录影像学上的局部椎体后凸、脊柱侧凸和身高丢失情况。
对数据进行统计学分析，结果如下。胸腰椎骨折在年轻成年人（<26岁）中更为常见，男性更为多见（80%的病例）。本研究中最常见的骨折类型是压缩骨折。本研究中最常受累的部位是L1椎体（36.7%）。79%的病例VAS评分（疼痛评分）显著降低，A1型骨折降低最多。本研究中RMDQ-测量的平均残疾评分为5.53。后凸畸形的总体进展为1.9°。未发现后凸畸形与临床结果（VAS和RMDQ-24评分）之间存在关联。与基线相比，2年后椎管大小变化不显著。
研究表明，在恢复日常活动方面有良好的结果，使其成为治疗A1型胸腰椎骨折的一个好选择。虽然存在后凸畸形进展，但未出现神经功能缺损。
