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创伤性胸腰椎骨折后的长期功能预后

Long-Term Functional Outcomes after Traumatic Thoracic and Lumbar Spine Fractures.

作者信息

Marek Ashley P, Morancy Jean Dominique, Chipman Jeffrey G, Nygaard Rachel M, Roach Robert M, Loor Michele M

出版信息

Am Surg. 2018 Jan 1;84(1):20-27.

Abstract

The incidence of thoracolumbar spine fractures in blunt trauma is 4 to 5 per cent. These fractures may lead to neurologic injury, chronic back pain, and disability. Most studies from United States trauma centers focus on neurologic sequelae and/or compare treatment modalities. However, most patients with spine fractures do not have a neurologic deficit. Our primary objective was to determine the long-term outcome of traumatic thoracolumbar spine fractures, specifically addressing quality of life, chronic pain, and employment using a validated patient outcome survey. A chart review of 138 adult blunt trauma patients who sustained a thoracolumbar spine fracture and were admitted to our Level I trauma center from 2008 to 2013 was performed. A phone interview based on the Short-Form 12®, a general health survey, was then conducted. Of the 134 patients who met the inclusion criteria, 46 (34%) completed the survey. The average Short-Form 12® scores were 51.0 for the physical health component score and 52.9 for the mental health component score. These did not differ significantly from the national norm. Furthermore, 83 per cent (38) of the survey respondents returned to work full-time at the same level as before their injury. Majority of the patients (76%) said they did not have pain two to seven years after injury. Despite a commonly held belief that back injury leads to chronic pain and disability, after sustaining a thoracic or lumbar fracture, patients are generally able to return to work and have a comparable quality of life to the general population. This knowledge may be useful in counseling patients regarding expectations for recovery from trauma.

摘要

钝性创伤中胸腰椎骨折的发生率为4%至5%。这些骨折可能导致神经损伤、慢性背痛和残疾。美国创伤中心的大多数研究都集中在神经后遗症和/或比较治疗方式。然而,大多数脊柱骨折患者并无神经功能缺损。我们的主要目标是确定创伤性胸腰椎骨折的长期预后,具体通过一项经过验证的患者预后调查来评估生活质量、慢性疼痛和就业情况。我们对2008年至2013年期间入住我院一级创伤中心的138例成年钝性创伤性胸腰椎骨折患者进行了病历回顾。随后基于一般健康调查简式12®进行了电话访谈。在符合纳入标准的134例患者中,46例(34%)完成了调查。身体健康成分得分的平均简式12®评分为51.0,心理健康成分得分为52.9。这些得分与全国标准无显著差异。此外,83%(38例)的受访者恢复了与受伤前相同水平的全职工作。大多数患者(76%)表示受伤两到七年后没有疼痛。尽管人们普遍认为背部受伤会导致慢性疼痛和残疾,但在遭受胸椎或腰椎骨折后,患者通常能够重返工作岗位,生活质量与普通人群相当。这些信息可能有助于为患者提供有关创伤恢复预期的咨询。

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