Is There an Association With Spino-Pelvic Relationships and Clinical Outcome of Type A Thoracic and Lumbar Fractures Treated Non-Surgically?

Author(s)

Joaquim, Andrei Fernandes ^[1] ; Rodrigues, Sergio Augusto ^[2] ; Da Silva, Felipe Soares ^[1] ; Da Silva, Otavio Turolo ^[1] ; Ghizoni, Enrico ^[1] ; Tedeschi, Helder ^[1] ; Schroeder, Gregory D. ^[3] ; Vaccaro, Alexander R. ^[3] ; Patel, Alpesh A. ^[4]

Affiliation

^[1] State Univ Campinas UNICAMP, Dept Neurol, Div Neurosurg, Campinas, SP - Brazil

^[2] State Univ Sao Paulo UNESP, Dept Bioproc & Biotechnol, Botucatu, SP - Brazil

^[3] Thomas Jefferson Univ, Rothman Inst, Dept Orthopaed Surg, Philadelphia, PA 19107 - USA

^[4] Northwest Univ, Dept Orthoped, Chicago, IL - USA

• Document type: Journal article
• Source: INTERNATIONAL JOURNAL OF SPINE SURGERY; v. 12, n. 3, p. 371-376, JAN 1 2018.
• Web of Science Citations: 1

Abstract

Background: The objective was to evaluate if there is an association of the spino-pelvic relationships and the global spinal alignment with the outcome of AO type A injuries treated nonsurgically. Methods: This is a retrospective case series. Patients treated nonsurgically for AOSpine type A fractures (T1-L5) with at least 1 year follow-up identified. A standing antero-posterior and lateral 36-inch radiographs and measures of spino-pelvic relationships and sagittal alignment were obtained, as well as clinical assessment using the visual analog scale, the Short-Form 36 (SF-36) questionnaire, the Oswestry Disability Index (ODI), and labor status. Results: Twenty-two patients with 33 fractures were included (L1 was the most injured level with 18.2%). There were 17 men (77.2%) and the mean age was 47.1 years. Follow-up ranged from 12 to 60 months (mean of 27.8 months). There were 22 type A1 (66.7%), 3 type A2 (9%), 6 type A3 (18%), and 2 type A4 (6%) fractures. The ODI ranged from 4% to 58%, with a mean of 24.4%. The SF-36 physical health score ranged from 23 to 82.25 (mean 49.59), and the mental health score ranged from 14.75 to 94.25 (mean 63.28). No association was identified between the spino-pelvic measurements, global alignment, and patient-reported outcomes. Conclusions: Type A fractures had a clinically relevant amount of long-term disability even when surgical treatment is not required. Spino-pelvic relationships and final global spinal alignment did not associate with outcome measurements. Lumbar Spine (AU)

• FAPESP's process: 15/09848-8 - Clinical and functional evaluation of patients with compression and burst thoracolumbar fractures treated non surgically
• Grantee: Felipe Soares da Silva
• Support Opportunities: Scholarships in Brazil - Scientific Initiation