Compression rates and kyphosis angles after 1 year in the patients with ao type a thoracic, thoracolumbar, and lumbar fractures treated conservatively

Abstract

ABSTRACTinjury classification and severity score (TLICS), described by Vaccaro et al. (7). In this system, most type A fractures of the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification system, even burst-type fractures in the thoracolumbar junction that had usually been operated on before, are classified within the conservative treatment group █ INTRODUCTION T raumatic spinal fractures are quite common lesions. In recent years, there has been a trend towards conservative treatment instead of surgery for thoracic, thoracolumbar, and lumbar fractures. This is partly due to the widening usage of a new classification system, thoracolumbar 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. The aim of this study was to determine the risk factors, and compression and kyphosis rates after 1 year in patients with AO type A thoracic, thoracolumbar, and lumbar fractures treated conservatively. MATERIAL and METHODS:Radiological and clinical results of 79 thoracolumbar fractures in 57 patients, who were treated conservatively, were evaluated one year after trauma. Fractures were classified according to thoracolumbar injury classification and severity (TLICS) 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, fractures in patients older than 60 years, those with osteoporosis or osteopenia, fractures located in the thoracolumbar junction, solitary fractures, and fractures in AO type A2 or A3, are more inclined to increase in compression and kyphosis and may require a closer follow-up.

Analysis of Influencing Factors of Vertebral Height Loss After Pedicle Screw Fixation of Thoracolumbar Fracture

“…However, bone volume in normal populations varies widely by sex, age, and occupation, with potential implications for fracture prognosis. Studies have confirmed that OSTA is based on the data of the patient’s body weight and age, which can be easily obtained and can approximately reflect bone mass 9–11 . In this study, the original application of OSTA as a bone mass indicator to evaluate its effect on postoperative VHL.…”

“…At present, the worldwide research on the influencing factors of VHL after thoracolumbar fractures is limited to sex, age, bone mineral density, BMI, and so on. There are also studies on the influence of pedicle screw fixation on the loss of postoperative vertebral height in thoracolumbar fractures, such as the choice of operation, postoperative bed rest time, improper screw placement, and poor reduction 9,10 . However, none of these are the main influencing factors for postoperative vertebral body height loss.…”

“…There are also studies on the influence of pedicle screw fixation on the loss of postoperative vertebral height in thoracolumbar fractures, such as the choice of operation, postoperative bed rest time, improper screw placement, and poor reduction. 9 , 10 However, none of these are the main influencing factors for postoperative vertebral body height loss. In this study, the main risk factors for VHL after pedicle screw internal fixation for thoracolumbar fractures were investigated in depth through long-term follow-up of large sample sizes and well-documented patients.…”

“…Studies have confirmed that OSTA is based on the data of the patient's body weight and age, which can be easily obtained and can approximately reflect bone mass. [9][10][11] In this study, the original application of OSTA as a bone mass indicator to evaluate its effect on postoperative VHL. The results of univariate analysis and multivariate logistic regression analysis showed that there was a significant correlation between OSTA and postoperative VHL.…”

Automated detection and classification of acute vertebral body fractures using a convolutional neural network on computed tomography

“…In 2013, Vaccaro et al. incorporated a modified classification system called the AOSpine thoracolumbar spine injury classification system ( 7 ), which is a widely accepted and comprehensive classification system used for clinical practice and research ( 8 , 9 ). This classification system can guide treatment decisions and help with the formulation of surgical procedures ( 10 – 12 ).…”