Article

Epidémiologie et résultats fonctionnels et radiologiques d'une série prospective de 518 patients à 1 an
Abstract : Recent epidemiological data for spinal trauma in France are sparse.
However, increased knowledge of sagittal balance and the development of minimally
invasive techniques have greatly improved surgical management. OBJECTIVES: To
describe the epidemiology and management of traumatic vertebral fracture, and to
analyze evolution and risk factors for poor functional outcome at 1 year's
follow-up. METHODS: A prospective multicenter French cohort study
was performed over a 6-month period in 2011, including all cases of vertebral
fracture surgery. Data were collected by online questionnaire over the Internet.
Demographic characteristics, lesion type and surgical procedures were collected.
Clinical, functional and radiological assessment was carried out at 1 year.
RESULTS: Five hundred and eighteen patients, with a mean age of 47 years, were
included. Sixty-seven percent of fractures involved the thoracic or lumbar
segment. Thirty percent of patients had multiple fractures and 28% neurological
impairment. A minimally invasive technique was performed in 20% of cases and
neurological decompression in 25%. Dural tear was observed in 42 patients (8%).
Seventy percent of patients were followed up at 1 year. Functionally, SF-36
scores decreased on all dimensions, significantly associated with age, persistent
neurological deficit and previous spine imbalance. Thirty-eight percent of
working patients had returned to work. Radiologically, sagittal balance was good
in 74% of cases, with fracture consolidation in 70%. DISCUSSION: Despite progress
in management, spinal trauma was still a source of significant morbidity in 2011,
with pronounced decrease in quality of life. Conserved sagittal balance appeared
to be associated with better functional outcome.
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Langue : FRANCAIS