Relationship between Neural Canal Impingement and Neurologic Status after Thoracolumber Burst Fractures

Cho, Hyoun Oh; Kwak, Kyung Duk; Cho, Sung Do; Suh, Jung Hwan

Abstract

In the assessment of thoracolumbar fractures, computed tomography (CT) is superior to other imaging modalities especially when a more definitive assessment of the posterior elements of the spine or the neural canal is desired. We evaluated 55 patients with acute thoracolumbar burst fractures, and correlated the amount of neural canal impingement (NCI), demonstrated on computed tomographic scans, with each patients neurologic status, level of injury and extent of recovery when neural deficit was present. The results were as follows ; l. Average NCI was significantly higher in cases with neurologic deficits (57.3%) than in cases with no deficit (29.8%). But the range of NCI was much overlapped between the two groups (32-100% with deficits vs. 8-69% with no deficit). 2. In cases with neurologic deficits, average NCI was significantly higher in lumbar spine (75.0%, range; 61-100%) than in thoracolumbar spine (49.2%, range; 32-87%). 3. There was no neurologic deficit in cases with NCI less than 30% in thoracolumbar spine and less than 60% in lumbar spine. 4. In thoracolumbar spine, there was more significant relationship between NCI and patient's neurologic status in T12 than in Ll. 5. The NCI did not directly correlate with the extent of recovery of neurologic deficits when present.