Turkish Neurosurgery
Compression rates and kyphosis angles after 1 year in the patients with AO type A thoracic, thoracolumbar, and lumbar fractures treated conservatively
Feyza Karagoz Guzey1, Burak Eren1, Azmi Tufan1, Ozgur Aktas1, Cihan Isler2, Mustafa Vatansever1, Abdurrahim Tas1, Eyup Cetin1, Murat Yucel1, Mustafa Ornek1
1Bagcilar Training and Research Hospital, Neurosurgery, İstanbul,
2Cerrahpasa Medical Faculty, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.19363-16.1

Aim:Conservative treatment is a frequently used treatment modality for traumatic thoracolumbar fractures. However, not many studies evaluating radiological and clinical results of conservative treatment are found.Material and Methods:Radiological and clinical results of 79 thoracolumbar fractures in 57 patients treated conservatively were evaluated one year after trauma. Fractures were classified according to thoracolumbar injury severity score and AO spinal trauma classification system. Compression rate, wedge and kyphosis angles, and sagittal index were calculated in early and late periods after trauma.Results:Female/male ratio was 25/32, and mean age was 41.7±16.7 years. They were followed for 15.2±4.9 months. Mean compression rates were 19.6% and 25.2%, wedge angles were 10.1 and 12.7 degrees, kyphosis angles were 5.82 and 8.9 degrees, and sagittal indexes were 8.01 and 10.13 in all patients just after trauma and after one year, respectively. Fractures in older patients (>60 years of age) and in patients with osteopenia or osteoporosis, located in the thoracolumbar junction, AO type A2 and A3 fractures, and solitary fractures had higher compression and kyphosis rates at last follow-up.Conclusion:Early mobilization without bed rest for stable thoracolumbar fractures according to the TLICS system is a good treatment option, and radiological and clinical results are usually acceptable. However, results of this study showed that fractures in patients older than 60 years of age, those with osteoporosis or osteopenia, fractures located in the thoracolumbar junction, solitary fractures, and fractures in AO type A2 or A3 were more inclined to increase in compression and kyphosis and may require a closer follow-up.

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