Is there an association with spino-pelvic relationships and clinical outcome of type a thoracic and lumbar fractures treated non-surgically?

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Data

2018-06-01

Autores

Joaquim, Andrei Fernandes
Rodrigues, Sérgio Augusto [UNESP]
da Silva, Felipe Soares
da silva, Otávio Turolo
Ghizoni, Enrico
Tedeschi, Helder
Schroeder, Gregory D.
Vaccaro, Alexander R.
Patel, Alpesh A.

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Resumo

Background: The objective was to evaluate if there is an association of the spino-pelvic relationships and the global spinal alignment with the outcome of AO type A injuries treated nonsurgically. Methods: This is a retrospective case series. Patients treated nonsurgically for AOSpine type A fractures (T1-L5) with at least 1 year follow-up identified. A standing antero-posterior and lateral 36-inch radiographs and measures of spino-pelvic relationships and sagittal alignment were obtained, as well as clinical assessment using the visual analog scale, the Short-Form 36 (SF-36) questionnaire, the Oswestry Disability Index (ODI), and labor status. Results: Twenty-two patients with 33 fractures were included (L1 was the most injured level with 18.2%). There were 17 men (77.2%) and the mean age was 47.1 years. Follow-up ranged from 12 to 60 months (mean of 27.8 months). There were 22 type A1 (66.7%), 3 type A2 (9%), 6 type A3 (18%), and 2 type A4 (6%) fractures. The ODI ranged from 4% to 58%, with a mean of 24.4%. The SF-36 physical health score ranged from 23 to 82.25 (mean 49.59), and the mental health score ranged from 14.75 to 94.25 (mean 63.28). No association was identified between the spino-pelvic measurements, global alignment, and patient-reported outcomes. Conclusions: Type A fractures had a clinically relevant amount of long-term disability even when surgical treatment is not required. Spino-pelvic relationships and final global spinal alignment did not associate with outcome measurements.

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Burst, Compression, Conservative treatment, Fractures, ODI, Outcome, Sagittal balance, SF-36, Spinopelvic relationships, Thoracolumbar, TLICS, VAS

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International Journal of Spine Surgery, v. 12, n. 3, p. 371-376, 2018.

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