Original Article

THE EVALUATION OF THE THORACOLUMBAR REGION INTERSPINOUS DISTANCE IN THE NEUTRAL AND HIPERFLEXION POSITIONS IN THE NORMAL INDIVIDUALS

  • Berk GÜÇLÜ
  • İ. Teoman BENLİ
  • Alper KAYA
  • Doğaç KARAGÜVEN
  • Murat KÖKEN

J Turk Spinal Surg 2009;20(4):19-28

The most important complications of the thoracolumbar fractures that are most frequent seen fractures of the vertebrae are neurological deficit and spinal instability. These two complications compose most important surgical indications. Recent years, the classification “Thoracolumbar Injury Classification and Scoring system (TLICS)" that developed by Spinal Trauma Group is a guide for decision making for surgery, while controversy continues in the spinal instability concept. But, descriptions about posterior ligamentous complex (PLC) have qualitative evaluations in this classification system. The aim of this study is to distinguish the interspinous distance (ISD) values both in neutral position in PLC intact healthy persons, and in hyperflexion that means ISD reaches maximum value. For this reason, ISD between T11-T12-L1 spinous process measured with radiology images in 20-40 years old 40 healthy volunteer males who did not have any trauma, spinal disorder or spinal surgery history. Patient demographics were determined homogeneous in age, weight, length and measured distances. Distances in neutral position between T11-T12 and T12-L1 were measured 11.7 ± 1.7 mm and 12.7 ± 1.5 mm, respectively, and values increased mean 26.5 ± 15.0 % and 24.4 ± 16.6 %, respectively in hyperflexion. The difference between in both two levels were statistically significant (p<0.05) while the percentages of differences found statistically similar (p>0.05). The difference of interspinous distance between T11-T12 and T12-L1 was found 5 mm and 4.9 mm, respectively. In healthy patients who are in the average age of the most common ages of the vertebral fractures occur, if the interspinous distance values in these levels are smaller than the appointed values, it can be said that the PLC is intact and the score can be taken as zero. According to the data of this study it was concluded that, in the thoracolumbar region that is most common site of the vertebral fractures, in the TLICS system that validity and reliability studies done in recent years, determination of the integrity of the PLC in one of the important steps, with quantitative measurement instead of qualitative analyses can be done for decision making.

Keywords: Thoracolumbar spinal fractures, classification, surgical treatments, TLICS