Closed therapy of thoracic and lumbar vertebral body fractures in trauma patients.

Autor:	Walters JW; Department of Surgery, The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona Maricopa Medical Center, Phoenix, USA., Kopelman TR; Division of Trauma, The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona Maricopa Medical Center, Phoenix, USA., Patel AA; The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona, USA., O'Neill PJ; Division of Trauma, The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona Maricopa Medical Center, Phoenix, USA., Hedayati P; Department of Radiology, The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona Maricopa Medical Center, Phoenix, USA., Pieri PG; Division of Trauma, The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona Maricopa Medical Center, Phoenix, USA., Vail SJ; Division of Trauma, The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona Maricopa Medical Center, Phoenix, USA., Lettieri SC; Division of Plastic Surgery, The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona Maricopa Medical Center, Phoenix, USA.; Division of Plastic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA., Feiz-Erfan I; Division of Neurosurgery, The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona Maricopa Medical Center, Phoenix, USA.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2017 Nov 20; Vol. 8, pp. 283. Date of Electronic Publication: 2017 Nov 20 (Print Publication: 2017).
DOI:	10.4103/sni.sni_336_17
Abstrakt:	Background: The failure rate for the closed/non-surgical treatment of thoracic and lumbar vertebral body fractures (TLVBF) in trauma patients has not been adequately evaluated utilizing computed tomography (CT) studies. Methods: From 2007 to 2008, consecutive trauma patients, who met inclusion criteria, with a CT diagnosis of acute TLVBF undergoing closed treatment were assessed. The failure rates for closed therapy, at 3 months post-trauma, were defined by progressive deformity, vertebral body collapse, or symptomatic/asymptomatic pseudarthrosis. The Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification was utilized to classify the fractures (groups A1 and non-A1 fractures) and were successively followed with CT studies. Results: There were 54 patients with 91 fractures included in the study; 66 were A1 fractures, and 25 were non-A1 fractures. All had rigid bracing applied with flat and upright X-ray films performed to rule out instability. None had sustained spinal cord injuries. Thirteen patients (24%) failed closed therapy [e.g. 13 failed fractures (14%) out of 91 total fractures]. Five failed radiographically only (asymptomatic), and eight failed radiographically and clinically (symptomatic). A1 fractures had a 4.5% failure rate, while non-A1 fractures failed at a rate of 40%. Conclusion: Failure of closed therapy for TLVBF in the trauma population is not insignificant. Non-A1 fractures had a much higher failure rate when compared to A1 fractures. We recommend close follow-up particularly of non-A1 fractures treated in closed fashion using successive CT studies. Competing Interests: There are no conflicts of interest.
Databáze:	MEDLINE
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