ABSTRACT

Summary of Background Data:

Neurologic status and mechanic stability have had the priority to evaluate the outcome of thoracic and lumbar spine fractures. Recently, studies evaluating functional status and life quality of the patients have gained popularity. When we review the literature we can see that this type of studies mostly have follow-up period of several years.

Objective:

To evaluate the long term outcome of surgically treated patients with thoracolumbar fractures without neurologic injury.

Materials and Method:

In this study long term functional and radiologic results of surgically treated patients with traumatic thoracolumbar fractures with neurologic injury. Forty- three patients were included in the study. The mean age at the time of injury and at the last visit was 39 ± 13.85 (17–71) and 48 ± 14.25 (23–77) respectively. Of them 28 were male (65.1 %), and 15 were female (34.9 %). distribution of the fractures were 5%, 74% and 21% in thoracic, thoracolumbar and lumbar spine respectively. Most commonly used approach was posterior instrumentation in 18 patients (48 %) followed by combined anteriorposterior approach in 14 (32.6 %) patients and anterior approach in 11 (25.6 %) patients. Questionnaires regarding functional status, pain level, and general health (Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), Visual Analogue Scale Spine Score (VASSS), Short Form 36 (SF–36), Short Form 12 (SF–12), Visual Analogue Score (VAS), Denis pain and work scales) were applied to the patients. Also radiographs of the whole spine and focused radiographs of the fracture were obtained at the last visit.

Results:

Nine (21%) patients had complications. The mean scores of outcome instruments were as follows; ODI, 19.10 ± 18.63 (0–70); RMDQ, 6.70 ± 6.42 (0–23); VASSS, 72.99 ± 20.45 (15–100); VAS, 2.7 ± 1.9. According to Denis work scale 18 (51.4 %) of the 35 patients returned to their previous jobs. Although pain scores were higher of the patients with a follow-up of more than 8 years there was no statistical difference in functional disability and general health scores (p>0.05).

Conclusion:

In this study we concluded as fracture and approach type, fracture level, length of hospital stay did not affect the long term outcome of the patients and clinical results of surgical treatment is acceptable in general. In addition, although the pain levels increased after 8 years of follow-up does not seem to affect the daily basis activities at the same magnitude. Under the light of present data we can say that surgical treatment of thoracic and lumbar spine fractures with correct indication can have satisfactory and good results for the long term.