J Korean Soc Spine Surg.  2009 Mar;16(1):1-7. 10.4184/jkss.2009.16.1.1.

The Analysis of Prognostic Factors on Unstable Burst Fracture on the Thoracolumbar Spine

• Lee KY
• Lee MJ
• Sohn SK
• Kim HJ

• KMID: 1473383
• DOI: http://doi.org/10.4184/jkss.2009.16.1.1

Abstract

STUDY DESIGN: A retrospective clinical and radiological analysis
OBJECTIVES
To determine the relationship between the classifications of unstable burst fractures on the thoracolumbar region, radiologic studies, signal change area on MRA and analysis of the prognostic factors. SUMMARY OF LITERATURE REVIEW: MRI is the first imaging modality that visualizes the extent of spinal cord derangement directly and it has the potential to provide an accurate diagnosis and prognosis.
MATERIALS AND METHODS
From March 1998 to September 2006, 39 patients who were eligible for a follow up of more than 1 year with an unstable burst fracture on the thoracolumbar region were studied. With these cases, The size of the bone fragment at the initial injury, signal change area on MRI, time to surgery, reduction rate of the bone fragments, recovery of the posterior curvature of the vertebrae and height of the vertebral body were analyzed.
RESULTS
The mean fracture size rate, average time to surgery, reduction rate of bone fragment and the recovery rate of the height of the vertebral body was 46.1+/-12.8%, 17+/-4.5 hours, 35.2+/-10.1%, and 57.9+/-17.4%, respectively. The data shows that the time elapsed until surgery had no relationship with the prognosis (P=0.317). Injuries with broad signal changes on MRI were not associated with the reduction rate of bone fragments, recovery of posterior curvature of the vertebrae and the height of the vertebral body.
CONCLUSIONS
In unstable burst fractures of the thoracolumbar region, although a comparison of the prognostic factors on simple X-ray film had no significance, it still has significant meaning when correlated with the signals on MRI.

Keyword

Thoracolumbar spine; Unstable burst fracture; Prognostic factors

MeSH Terms

Follow-Up Studies
Humans
Prognosis
Retrospective Studies
Spinal Cord
Spine
X-Ray Film

Figure

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  Fig. 1. CT scan shows retropulsed fragment into the spinal canal.

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  Fig. 2. AP and lateral views of preoperative state, kyphotic angle was 24.8 degrees, reserver rate was 24%.

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  Fig. 3. Immediately postoperative state, kyphotic angle was 10.6 degrees, reserver rate was 37%.

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  Fig. 4. Six months after operation, kyphotic angle was 4 degrees, reserver rate was 40%.

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  Fig. 5. Quantitative analysis of signal changes on MRI.

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