Spinal Cord Alignment in Patients with Thoracolumbar Burst Fracture

Rev Bras Ortop, 2023 · DOI: https://doi.org/10.1055/s-0042-1756322 · Published: March 24, 2023

Trauma Orthopedics Musculoskeletal Medicine

Simple Explanation

This study looks at the alignment of the spine and pelvis in patients who have a specific type of spinal fracture (thoracolumbar burst fracture) without neurological problems. The patients were treated either with surgery or without surgery, and researchers analyzed their clinical data and radiographic images to see if there were any differences in their spinal alignment. The study found that while the overall alignment was generally normal, there were some differences in pelvic position and the relationship between the lumbar spine and pelvis compared to people without these fractures.

Study Duration

109 months mean follow-up (minimum 19, maximum 306 months)

Participants

50 individuals with thoracolumbar burst fracture

Evidence Level

Not specified

Key Findings

1
No significant difference was found between surgical and non-surgical treatments for lower back pain, Denis Pain Scale, or SF-36 domains.
2
Radiographic parameters showed no significant difference between surgical and non-surgical groups.
3
All radiographic parameters showed significant difference between the study population and asymptomatic individuals, except for pelvic incidence.

Research Summary

The study evaluated spinopelvic alignment in patients with thoracolumbar burst fractures (TBF) without neurological deficits treated surgically and non-surgically. The results showed no significant difference between treatments for low back pain, pain scales, or quality of life. Radiographic parameters were not different between the treatment groups. Patients with TBF had normal spinopelvic alignment after a minimum of 19 months follow-up but showed higher pelvic version and discrepancy between lumbar lordosis and pelvic incidence compared to the general population.

Practical Implications

Treatment Choice

Both surgical and non-surgical treatments may lead to similar outcomes in terms of pain and quality of life for thoracolumbar burst fractures without neurological deficits.

Pelvic Compensation

Patients with thoracolumbar burst fractures may develop compensatory mechanisms in the pelvis to maintain spinal alignment.

Long-term Monitoring

Long-term follow-up is important to monitor changes in spinopelvic alignment and to detect any potential issues that may arise over time.

Study Limitations

1
Cross-sectional study design limits conclusions on causality.
2
Potential loss to follow-up bias due to the study setting within the Brazilian Unified Health System.
3
The patients evaluated were all who returned to the outpatient clinic.

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