E-ISSN: 2147-5903
THE EFFICIENCY OF CONSERVATIVE TREATMENT OF THE THORACOLUMBAR VERTEBRAE COMPRESSION FRACTURES
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Original Article
VOLUME: 20 ISSUE: 4
P: 29-36
October 2009

THE EFFICIENCY OF CONSERVATIVE TREATMENT OF THE THORACOLUMBAR VERTEBRAE COMPRESSION FRACTURES

J Turk Spinal Surg 2009;20(4):29-36
D. Ali ÖÇGÜDER 1
Erkan AKGÜN 2
Tolga TOLUNAY 1
Ferhat GÜLER 3
Hasan OĞUR 4
Şükrü SOLAK 5
1. Ortopedi ve Travmatoloji Uzmanı, Atatürk Eğitim ve Araştırma Hastanesi, 2. Ortopedi ve Travmatoloji Kliniği, Ankara.
2. Araştırma Görevlisi, Atatürk Eğitim ve Araştırma Hastanesi, 2. Ortopedi ve Travmatoloji Kliniği, Ankara.
3. Ortopedi ve Travmatoloji Uzmanı, Elazığ Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Elazığ
4. Ortopedi ve Travmatoloji Uzmanı, Batman Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Batman
5. Doç. Dr., Klinik Şef Muavini, Ortopedi ve Travmatoloji Uzmanı, Atatürk Eğitim ve Araştırma Hastanesi, 2. Ortopedi ve Travmatoloji Kliniği, Ankara
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ABSTRACT

Objective:

The evaluation of the radiologic and functional efficiency of conservative treatment of the thoracolumbar vertebrae fractures has been aimed.

Material and Methods:

The study included 25 patients (16 males, 9 females; mean age 38.8; range 20 to 59 years) who underwent conservative treatment for traumatic thoracolumbar vertebrae compression fractures. All of the patients were assessed by plain radiograms and computed tomography. None of the patients had neurological deficits. Treatment involved use of a thoracolumbosacral hyperextension orthesis for four to six months. Radiographically, local kyphosis angle and sagittal index were measured before and after treatment for evaluating the efficiency of treatment. Functional results were evaluated with the use of Denis’ pain and work scales. The mean follow-up was 4.1 years (range 3 to 7 years).

Results:

The mean hospital staying time was 3.8 days (range 3 to 7 days). None of the patients had late term neurological deficits and cardiovascular complications. Before treatment, the mean local kyphosis angle and sagittal index were measured as 16.8° ± 4.7° and 14.2° ± 3.6°, after treatment they were measured as 17.1° ± 5.2° and 14.7° ± 4.5°. However, both did not differ significantly from the baseline at the final measurements (p>0.05). After treatment, the mean Denis’pain and work scales scores were 1.92 and 1.76, respectively with statistically importance (p<0.05). One patient required surgery at 11th month because of pain (Denis’ score; P4-W3, local kyphosis angle; 28, sagittal index; 22).

Conclusions:

In this study, although in the thoracolumbar vertebrae compression fractures there has not been any substantial change radiologically in the local kyphotic deformation, it has been observed that there is an important improvement in the results of clinical studies. Under the scope of this study, it has been concluded that although only one patient has been sent to surgery, treatment with ortesis is very effective in the thoracolumbar compression fractures under proper indications.

Keywords:
Thoracolumbar region, vertebrae fractures, non-surgical treatment