Non-operative treatment of thoracolumbar fractures

Between 1986 and 1992, 32 thoracolumbar fractures in 32 patients were treated nonoperatively with 4-6 weeks on a rotorest bed followed by bracing with a thoracolumbosacral orthosis for a total of 3-6 months. The fractures were classified as 20 burst, six fracture dislocations, five severe compressio...

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Bibliographic Details
Published in:Paraplegia 1995-02, Vol.33 (2), p.73-76
Main Authors: HARTMAN, M. B, CHRIN, A. M, RECHTINE, G. R
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Female
Follow-Up Studies
Fractures, Bone - therapy
Humans
Injuries of the limb. Injuries of the spine
Joint Dislocations
Lumbosacral Region - injuries
Male
Medical sciences
Middle Aged
Thoracic Injuries - therapy
Traumas. Diseases due to physical agents
Treatment Outcome
Wounds and Injuries
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Summary:Between 1986 and 1992, 32 thoracolumbar fractures in 32 patients were treated nonoperatively with 4-6 weeks on a rotorest bed followed by bracing with a thoracolumbosacral orthosis for a total of 3-6 months. The fractures were classified as 20 burst, six fracture dislocations, five severe compression fractures, and one gunshot wound. There were 12 multilevel fractures. Nine patients had incomplete neurological injuries and three had complete neurological injuries. The average age was 36.8 years (range 17-63) and the average follow-up was 22.3 months (range 12-60). Fifty three percent (17/32) of these had multisystem injuries including visceral trauma and long extremity fractures. There were only two complications; a deep vein thrombosis and a heel ulcer. Neither of these complications extended the patients' hospital stay. All nine of those with incomplete neurological injuries improved at least one Frankel grade. Fifteen of 24 patients who were employed returned to their previous jobs, and only nine patients had persistent back pain requiring medication. Surgical treatment of thoracolumbar fractures is often favored over conservative treatment in the multitrauma and neurologically injured patient because of complications related to bedrest. However, by using a rotorest bed and aggressive physical therapy, conservative treatment may actually result in lower morbidity.
ISSN:0031-1758
1362-4393
1476-5624
DOI:10.1038/sc.1995.18