J Korean Soc Spine Surg.  1997 Nov;4(2):249-256.

Long Term Follow-up of the Stable Fractures Around Thoracolumbar Spinal Junction (Conservative Management vs. Operative Intervention)

• Ahn JS
• Lee JK
• Lee SJ

Abstract

STUDY DESIGN: The treatment of a stable fracture around thoracolumbarjunction is a controversial subject.
OBJECTIVES
To evaluate the result from long term follow-up of the stable spinal fracture around thoracolumbar junction according to the operation, osteoporosis and in situ extension bar, respectively. SUMMARY OF BACKGROUND DATA: The thoracolumbar junction is a transitional zone in which the kyphotic angle of thoracic spine is continued to the lordotic angle of lumbar splne. So it is prone to be injured biomechanically, and the stability of the spine around thoracolumbar junction is not determined yet.
METHODS
We studied retrospectively 105 cases of the stable fracture around thoracolumbar junction from January 1985 to December 1995. The criteria of the stability were a compression fracture by Denis F., a bursting fracture without involvement of posterior column, a neural enchroachment of bony fragment below 30%, fracture without subluxation or dislocation in spinal junction.
RESULTS
The most common cause was traffic accident and, the first lumbar vertebrate was common site. Below 30% of initial compression, the progression was not exceded 5% in operative group. But in nonoperative group, anterior compression was more progressed than initial compression over 5%. The degree of anterior compression was affected by osteoporosis and in situ extension bar just after injury.
CONCLUSIONS
We suggest an anterior compression abode 30% in spinal body of thoracolumbar junction for an additional operative indication. The prognosis may be affected by osteoporosis and in situ extension bar.

MeSH Terms

Accidents, Traffic
Dislocations
Follow-Up Studies*
Fractures, Compression
Osteoporosis
Prognosis
Retrospective Studies
Spinal Fractures
Spine
Vertebrates