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HE CONSERVATIVE TREATMENT OF THORACOLUMBAR FRACTURES THE RESULTS OF FIVE YEARS FOLLOW-UP

  • Erhan SESLİ
  • Alp VARILSÜHA
  • Halit ÖZYALÇIN
  • Bâtur IŞIK

J Turk Spinal Surg 2000;11(1):24-29

We present in this study the late results of conservatively treated 456 thoracolumbar vertebra fractures in our clinic from 1986 to 1996. The mean age of the patients was 39.5 (9-82) years. 257 cases were follovved for five years. Most of our patients had compression type fractures (n:388), follovved by burst type fractures (n:102). The distribution of the burst fractures according to the Deniş' classification vvas; superior end plate type 77, both end plate type 21, lateral deviation type 4.

The first aim in conservatively treated patients is to reduce the fracture and to hold it in an acceptable position by hyperextension posture. İn most of our cases, we performed hyperextension cast brace. İn some patients who vvere old and had osteoporotic fractures or minimal vvedge fractures, we preferred thoracolumbosacral orthosis (TLSO) initially. İn burst and compression fractures treated vvith hyperextension cast brace or TLSO, measured kyphosis angles before the treatment and at fhe last control vvere found significantly correlated (p<0.05). İn burst fractures, measured canal dimensions before the treatment and at the last control also vvere found significantly correlated (p<0.05). We did not observe neurological impairment in any case treated conservatively.

Evident improvement in kyphosis angles, statistically correlated end results and less seen late complications proved that conservative treatment is a successful method in appropriate cases.

Keywords: Thoracolumbar vertebra fractures, Conservative treatment, Hyperextension cast brace, Kyphosis angle