Article

Researches on the results of surgical treatment of thoracolumbar
spine fractures are infrequent. The aim of this study was to determine midterm
outcomes of surgical treatment of these fractures in a prospective survey.
METHODS: A case series study on pediatric patients with the diagnosis of thoracic
and/or lumbar vertebral fractures was conducted over a ten-year period.
Surgically treated patients were evaluated in the follow-up period, based on back
pain, independent function, neurological status, and radiographic indices.
RESULTS: There were 102 pediatric individuals, 61 boys and 41 girls, aged 3-17
years (mean 12 years of age) with thoracic and/or lumbar spinal fractures. Motor
vehicle accident was the most common mechanism of injury (45.0 %). L1 was the
most frequent level of fractured vertebra (24.4 %), and pelvic fracture was the
most common associated orthopedic injury (21.5 %). Totally, 20 patients underwent
surgery, but only fifteen (14 boys and one girl) participated in follow-up (mean
49 months; range 12-81 months). Posterior spinal fusion and instrumentation was
accomplished in 12 cases. Three patients were operated by anterior approach and
fusion followed by posterior fusion and instrumentation because of delay in
diagnosis. There were no major perioperative complications. Two cauda equina
syndromes and two incomplete spinal cord injuries improved back to normal. Five
cases (33.3 %) reported occasional back pain, and all patients were functionally
independent. Radiographic indices improved significantly. CONCLUSIONS: Spinal
fusion and instrumentation in pediatric patients with unstable thoracolumbar
vertebral fractures with or without spinal cord injuries have favorable
radiographic and functional outcomes.

Langue : ANGLAIS