Original Articles

THE ROLE OF CONSERVATIVE TREATMENT IN THE WORKING PATIENTS WITH COMPRESSION FRACTURES OF THE THORACOLUMBAR REGION WITHOUT NEURAL ABNORMALITY

  • Ahmet Özgür YILDIRIM
  • Özdamar Fuad ÖKEN
  • Yunus DEMİRTAŞ
  • Murat GÜLÇEK
  • Ahmet UÇANER

Received Date: 03.08.2011 Accepted Date: 29.11.2011 J Turk Spinal Surg 2012;23(1):35-44

Approximately of % 90 vertebral fractures are in the thoracolumbar junction. Patients with unstable fractures and neurological deficits are treated with surgery, stable fractures without neurological deficit are treated with conservative methods. Thirty nine patients (13 male, 26 female) with compression fractures were treated conservatively evaluated retrospectively. All the patients were evaluated with X- rays and computerize tomography. Local kyphosis and sagittal index angles were measured. Thoracolumbosacral hyperextension orthosis was used for all the patients for 4 months. Local kyphosis and sagittal index angles were also measured with control X- rays at the follow up. The functional results were evaluated with Denisʼ pain and work scale.

Themean values of the local kyphosis and sagittal index are 20.5° ± 4.8° ve 10.6° ± 3.8° degrees at the first visit. The mean values of the local kyphosis and sagittal index are 20.6° ± 4.5° ve 10.6° ± 3.8° degrees at the last follow up. These values were not statistically significant (p>0.05). The mean values of the pain scale are 3.6 ± 0.5 and the mean values of returning to work scale are 2.5 ± 0.6 at the first visit. There were not any differences between the beginning and the last follow up scales. At the present day the conservative treatment of the compression fractures of thoracolumbar junction is still an alternative treatment method. Finally we think that it is an effective method in the treatment of fractures which are stable compression fractures with local kyphosis and sagittal index under 30 degree in active working patients.Only one of our patients (% 2,6) could not return to his job. Although the adaptation of the patients to the orthosis is difficult; the conservative treatment is an effective and economic treatment method that does not affect returning to the work.

Keywords: Compression fractures, orthosis treatment, conservative treatment, thoracolumbar region