J Korean Orthop Assoc.  1999 Aug;34(4):659-664.

Results of Operative Treatment in Fracture-Dislocations of Thoracic and Lumbar Spine

Affiliations
  • 1Department of Orthopaedic Surgery, Hanyang University Kuri Hospital.

Abstract

PURPOSE
To analyze the complications and improvement of neurologic injury after operative treatment in the fracture-dislocations of thoracic and lumbar spine in long-term follow-up.
MATERIALS AND METHODS
A retrospective review of 39 patients, who were operated on for fracture-dislocations in thoracic and lumbar spine from May 1982 to May 1995 was conducted. We evaluated the result with Denis classification for type of fracture-dislocations and with Frankel classification for the neurologic injury. Average levels of fusion were 4.56 segments, ranging from 2 to 7 segments.
RESULTS
According to the Frankel classification, the most common neurologic status at initial presentation was grade A in 28 cases (71.8%) and cases with complete paraplegia showed no improvement in long-term follow-up at all. Six other cases with incomplete paraplegia showed average neurologic improvement of 1.5 grade. Ischial sore was most common (13 cases) complication.
CONCLUSIONS
Fracture-dislocations showed a higher incidence of neurologic injury than other spine fractures. Complete paraplegia was most common with no neurologic improvement in longterm follow-up. Incomplete paraplegia showed neurologic improvement. The cases of complete paraplegia had more complications than cases of incomplete paraplegia. The authors think that the postoperative care of complete paraplegia is important.

Keyword

Fracture-dislocations; Neurologic improvement; Postoperative care
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