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年轻患者爆裂骨折行360°胸腰椎融合术后恢复运动/活动水平的情况。

Return to sports/activity level after 360° thoracolumbar fusion after burst fractures in young patients.

作者信息

Aregger Fabian Cedric, Kreuzer Sebastian, Häckel Sonja, Bigdon Sebastian Frederick, Tinner Christian, Erbach Georg, Deml Moritz Caspar, Albers Christoph Emanuel

机构信息

Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital Bern, University Bern, Bern, Switzerland.

Department of Orthopaedic Surgery and Traumatology, Spital Thun, Thun, Switzerland.

出版信息

Brain Spine. 2024 Jan 23;4:102762. doi: 10.1016/j.bas.2024.102762. eCollection 2024.

Abstract

INTRODUCTION

Traumatic thoracolumbar burst fractures are the most common spinal injuries and the proper treatment is controversial. In central Europe in particular, these fractures are often treated with minimally invasive anterior-posterior reduction and fusion, whereas a conservative approach is preferred in the USA. Independent of the treatment strategy, no data exists regarding the outcome related to return to activity level/sport.

RESEARCH QUESTION

The aim of this study was to evaluate the return to sports and activity levels after 360° fusion in patients with thoracolumbar burst fractures without neurological deficits.

METHODS

Between January 2013 and December 2022, 46 patients aged 18 to 40 years underwent partial or complete vertebral body replacement in the thoracolumbar region due to traumatic burst fractures without neurologic deficit as an isolated injury. Patients were contacted retrospectively by phone calls to assess their activities using a modified version of the Tegner activity scale at different time points: Before trauma, 3, 6, and 12 months post-surgery.

RESULTS

After applying exclusion criteria, data collection was complete for 28 patients. The median modified Tegner activity scale was 5.4 before sustaining the fracture, declined to 2.9 at three months post-trauma, improved to 4.2 at six months, and reached 5.0 at 12 months. The majority (83%) of patients achieved their pre-accident activity level within 12 months. No significant differences were observed between patients with partial or complete corpectomy.

CONCLUSION

This is the first study assessing return to sports/physical activity based on the modified Tegner scale in young patients undergoing 360° fusion for spinal burst fractures. The majority of patients (83%) return to the pre-injury activity level within 12 months after surgery.

摘要

引言

创伤性胸腰椎爆裂骨折是最常见的脊柱损伤,其恰当的治疗方法存在争议。特别是在中欧,这些骨折常采用微创前后路复位融合术治疗,而在美国则更倾向于保守治疗。无论采用何种治疗策略,目前尚无关于恢复活动水平/运动相关结果的数据。

研究问题

本研究的目的是评估无神经功能缺损的胸腰椎爆裂骨折患者在接受360°融合术后恢复运动和活动水平的情况。

方法

2013年1月至2022年12月期间,46例年龄在18至40岁之间的患者因创伤性爆裂骨折且无神经功能缺损作为孤立损伤,在胸腰椎区域接受了部分或全椎体置换术。通过电话对患者进行回顾性随访,使用改良版的特格纳活动量表在不同时间点评估他们的活动情况:创伤前、术后3个月、6个月和12个月。

结果

应用排除标准后,28例患者的数据收集完整。骨折前改良特格纳活动量表的中位数为5.4,创伤后3个月降至2.9,6个月时改善至4.2,12个月时达到5.0。大多数(83%)患者在12个月内恢复到事故前的活动水平。部分或全椎体切除的患者之间未观察到显著差异。

结论

这是第一项基于改良特格纳量表评估接受脊柱爆裂骨折360°融合术的年轻患者恢复运动/身体活动情况的研究。大多数患者(83%)在术后12个月内恢复到受伤前的活动水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c28/10951747/5c47ad4fc046/gr1.jpg

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