Nonoperative treatment in burst fractures of the lumbar spine (L2-L5) without neurologic deficits.

Abstract:

:A retrospective review of 20 patients treated nonoperatively for burst fractures of the lumbar spine (L2-L5) was performed. All patients were neurologically intact at the time of injury. Follow-up averaged 3.9 years with a range of 2.1 to 9.1 years. Fourteen patients were men and six were women. The average age at injury was 35.8 years (8-67 years). Sixty-five percent of the injuries were the result of motor vehicle accidents and 35% falls from height. Fifty-five percent were two-column injuries and 45% three-column injuries. Kyphotic deformity averaged 8 at injury (-7 to 30) and 9.6 at follow-up (-8 to 33). Computed tomography scans were performed in nine patients during evaluation of injury. Spinal canal compromise averaged 40% (18-75%). Eighteen patients (90%) were considered to have a good to excellent functional outcome, whereas two patients had a fair outcome. No patient had a poor outcome. In no patient did neurologic deterioration or symptomatic spinal stenosis develop. Twenty-five percent of patients had no back pain, 70% mild back pain, and 5% moderate back pain. No patient was totally incapacitated by pain. Of those employed, all returned to full-time work. Nonoperative treatment should be considered as an alternative in the treatment of lumbar burst fractures (L2-L5) in patients presenting without initial neurologic deficits.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Chan DP,Seng NK,Kaan KT

doi

10.1097/00007632-199303000-00002

subject

Has Abstract

pub_date

1993-03-01 00:00:00

pages

320-5

issue

3

eissn

0362-2436

issn

1528-1159

journal_volume

18

pub_type

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