Kaya Mustafa
Department of Neurosurgery, Sakarya University Education and Research Hospital, Sakarya, TUR.
Cureus. 2024 Apr 6;16(4):e57700. doi: 10.7759/cureus.57700. eCollection 2024 Apr.
Background The aim of this study is to emphasize the need to be careful in terms of internal organ injuries in patients with isolated transverse process fracture (ITPF), and to investigate the effectiveness of corset use in controlling acute pain. Methods This is a retrospective study including 72 patients with only transverse process fractures secondary to trauma, who were admitted to the Emergency Department of Sakarya University Research and Training Hospital between January 2020 and October 2022. The radiological diagnoses were collected from spinal vertebral computed tomography images. Twelve patients were excluded from the study due to exclusion criteria. Sixty patients with ITPF were included in the comparison group. All patients were divided into two groups. The group with no lumbar corset (LC) included those who were discharged with analgesic and muscle relaxant treatment without a brace (n = 33). The LC+ group (n = 27) included those who received rigid lumbosacral orthosis in addition to analgesic and muscle relaxant treatment. Pain levels of all cases in both groups were evaluated with Visual Analog Scale scores on the day of trauma, the first week, the first month, and the sixth month. Results A total of 25 cases had one ITPF, 25 had two, 17 had three, and five patients had four or more ITPFs. The hospitalization rate was the highest among patients with four or more ITPFs (40%). Although the hospitalization rates according to the number of ITPFs were not statistically significant (p = 0.528), there was a clinical significance regarding increasing hospitalization rates with the increasing number of ITPFs. The hospitalization rates were 12%, 16%, 17.6%, and 40% in patients with one, two, three, and four or more ITPFs, respectively. Conclusion ITPFs should be treated conservatively. Concomitant organ injuries must be ruled out before treatment. Medical treatment without a lumbar corset could be used as a cost-effective choice.
背景 本研究的目的是强调在孤立性横突骨折（ITPF）患者中，对于内脏损伤需谨慎对待，并研究使用束腹带控制急性疼痛的有效性。方法 这是一项回顾性研究，纳入了2020年1月至2022年10月期间在萨卡里亚大学研究与培训医院急诊科就诊的72例仅因创伤导致横突骨折的患者。从脊柱计算机断层扫描图像中收集放射学诊断结果。12例患者因排除标准被排除在研究之外。60例ITPF患者被纳入比较组。所有患者分为两组。无腰托（LC）组包括那些接受镇痛和肌肉松弛剂治疗后未使用支具出院的患者（n = 33）。LC +组（n = 27）包括那些除了接受镇痛和肌肉松弛剂治疗外还接受了硬式腰骶矫形器治疗的患者。两组所有病例在创伤当天、第一周、第一个月和第六个月时均使用视觉模拟量表评分评估疼痛程度。结果 共有25例患者有1处ITPF，25例有2处，17例有3处，5例患者有4处或更多处ITPF。4处或更多处ITPF患者的住院率最高（40%）。尽管根据ITPF数量的住院率差异无统计学意义（p = 0.528），但随着ITPF数量增加住院率上升具有临床意义。1处、2处、3处以及4处或更多处ITPF患者的住院率分别为12%、16%、17.6%和40%。结论 ITPF应采用保守治疗。治疗前必须排除合并的器官损伤。不使用腰托的药物治疗可作为一种经济有效的选择。
