Conservative and operative treatment in cervical burst fractures

• Published in: Archives of orthopaedic and trauma surgery 2000, Vol.120 (7-8), p.448-451
• Main Authors: KOIVIKKO, M. P, MYLLYNEN, P, KARJALAINEN, M, VORNANEN, M, SANTAVIRTA, S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bone Transplantation; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - injuries; Cervical Vertebrae - surgery; Decompression, Surgical; Female; Fracture Fixation, Internal; Fractures; Humans; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Middle Aged; Neurologic Examination; Orthotic Devices; Postoperative Complications - diagnostic imaging; Radiography; Retrospective Studies; Spinal Cord Compression - diagnostic imaging; Spinal Cord Compression - surgery; Spinal Fractures - diagnostic imaging; Spinal Fractures - surgery; Spinal Fusion; Traction; Traumas. Diseases due to physical agents
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s004029900129

The aim of this study is to compare the results of non-operative and anterior operative treatment of cervical burst and flexion teardrop fractures. Sixty-nine consecutive patients treated during 1980 to 1995 were reviewed retrospectively. Thirty-four of them had been treated with skull traction or halo-vest and 35 with anterior decompression, bone grafting and fixation by an anterior Caspar plate. Neurological functioning on admission and at the end of the follow-up was assessed by using Frankel's classification. Kyphosis and spinal canal encroachment by retropulsed fragments were measured radiographically. Operatively treated patients recovered more often with at least one Frankel grade (P = 0.027) and presented less narrowing of the spinal canal (P = 0.0006) and kyphotic deformity (P = 0.00003) at the end of the followup. In comparison with the conservative methods, the operative Caspar technique provided superior decompression and fixation as well as promoted the healing of cord injuries caused by burst and flexion teardrop fractures.