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BACKGROUND: The highest incidence of spinal fracture is in the thoracolumbar segment, and its symptoms are back pain, posterior convexity deformity, activity limitation, or with spinal cord nerve injury causing lower limb pain, numbness, and even paraplegia and other complications. The finite element method is a digital computer modeling technique, which can simulate the physical model and carry out force analysis realistically. OBJECTIVE: To review the application of finite element method in thoracolumbar spine fractures. METHODS: We searched the Chinese and English literature databases PubMed, Web of Science, and CNKI for relevant literature on the application of the finite element analysis method in spinal thoracolumbar fracture published before March 2024. The search terms in Chinese and English were: finite element analysis methods, biomechanical phenomena, stress analysis, thoracolumbar fractures, spinal fractures. Finally, 55 papers were included. RESULTS AND CONCLUSION: (1) The exploration of thoracolumbar fractures caused by different etiologies (osteoporotic, traumatic, and pathological) through the finite element method is conducive to a deeper understanding of the biomechanics of various types of thoracolumbar fractures, and to improve the individualized and fine-tuned treatment of thoracolumbar fractures. (2) The finite element analysis of a single sample or a small number of samples has the chance, and a larger number of samples are required for the future finite element analysis to reduce the chance caused by the sample. (3) The rigid structure of bones alone cannot meet the biomechanical working conditions of the integrity of the physical object, and future finite element models need to incorporate all the structures of the physical object (e.g., soft tissues, such as muscles and ligaments) as far as possible. (4) The finite element method has been used in more studies on osteoporotic and traumatic thoracolumbar spine fractures, which will need to be more in-depth in the future, and less in the field of pathologic thoracolumbar fractures, which has a wider scope for future research. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aims to compare the utilization of 3D-CT reconstruction in measuring pedicle outer width (POW) between younger/middle-aged patients ( 0.05). In the observation group, both male and female patients had significantly smaller POW compared to the control group (P 0.05). In the observation group, the POW was less than 5 mm in 9.33% (81/868) of cases and less than 7 mm in 49.88% (433/868) of cases, primarily observed from T11 to L3. In the control group, 4.81% (31/644) of cases had a POW of less than 5 mm, and 13.81% (88/644) had a POW of less than 7 mm.ConclusionUtilizing preoperative 3D-CT reconstruction to measure POW in patients with TSF not only facilitates the assessment of surgical feasibility but also aids in surgical pathway planning, thus potentially reducing the incidence of postoperative complications.

Introduction: Differentiating an acute from chronic compression fracture of the thoracolumbar (TL) spine can pose a dilemma for radiologists interpreting spinal imaging following trauma. Mild wedging of the vertebrae can be due to spondylosis or osteoporosis, whilst acute simple compression fractures may not always be associated with loss of body height. In this observational study, we hypothesize that the presence of a vertebral body cortical step is a reliable sign of an acute compression fracture on Computed Tomography (CT) scans. Methods: In a retrospective review of thoracolumbar CT scans following trauma, two observers analysed for the presence of a cortical step at the anterior or posterior vertebral body cortex, fracture morphology and associated injuries. A 'cortical step' is defined as a break of hyperdense cortex on CT scans, intervening non-sclerosed trabecular bone, and sharp overlap of the underlying cortex. MRI of the spine was used as gold standard. Results: 187 consecutive CT scans over 2 years were assessed. Sensitivity, specificity and accuracy of cortical step sign were 100%, 90.2% and 97% in diagnosing an acute thoracolumbar compression fracture, respectively. The interobserver reliability was high (kappa = 0.97). False positive cortical step was seen in Kummel's disease and large Schmorl's nodule. Conclusion: Our results demonstrate high sensitivity and specificity of 'cortical step sign' in diagnosing acute vertebral body compression fractures of TL spine on CT scans in patients with trauma. This sign can be useful to radiologists for safe clearance of the thoracolumbar spine following trauma, helping distinguish acute trauma from chronic causes of vertebral body height loss. [ABSTRACT FROM AUTHOR]

Introduction: Thoracolumbar spine fracture is one of the commonest spinal fractures. The treatment of choice of surgery is still controversial. This is a retrospective analysis of clinical and radiological outcomes of long and short segment stabilization for patients admitted with thoracolumbar fracture in our hospitals. Material and Method: Inclusion criteria included a single level of thoracolumbar fracture, excluding pre-existing deformity or spinal surgery, osteoporosis, and pathological fracture. Clinical parameters included visual analogue scale (VAS), operative time, intraoperative blood loss, and postoperative length of stay. Radiological parameters included wedge angle and anterior and posterior vertebral height ratio. Results: From June 2007 to May 2020, 56 patients (male=31, female=25) were recruited. There were 25 patients in the short segment group (open= 11, minimal invasive surgery (MIS)=14) and 31 patients in the long segment group. Clinically, significantly better VAS at 6 months (1 vs. 1.96; p=0.041), shorter post-op length of stay (16 days vs. 25 days; p=0.01), and less blood loss (178 ml vs. 824 ml; p< 0.01) were found in the short segment group. Radiologically, the short segment group showed significantly better wedge angle at immediate (5° vs. 9.23°; p=0.002) and long-term follow-up (7.41° vs. 11.43°; p=0.01). Moreover, the short segment group has significantly better post-op anterior and posterior vertebral height ratios. Within the short segment group, the MIS group showed significantly less blood loss (82 ml vs. 303 ml; p <0.01). However radiological parameters favour the open group. Discussion and Conclusion: For single-level thoracolumbar fracture, both long and short stabilizations were effective in reducing and stabilizing the fracture. However, the short segment group showed significantly superior results. Moreover, a minimally invasive technique in short segment stabilization showed even less blood loss but less optimal radiological results. Therefore, short segment stabilization could be the treatment of choice for traumatic thoracolumbar spine fractures. [ABSTRACT FROM AUTHOR]

This review aims to search the epidemiology and incidence rates of thoracolumbar spine fractures. A systematic review of the literature of the last 10 years gave 586 results with “incidence,” and 387 results with “epidemiology,” of which 39 papers were analyzed. The review results were discussed and voted in 2 consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee. Out of 39 studies, 15 studies have focused on thoracolumbar trauma, remaining 24 studies have looked at all spine trauma. Most were retrospective in nature; few were prospective and multicenter. Some studies have focused on specific injuries. The annual incidence of TL fractures is about 30/100,000 inhabitants including osteoporotic fractures. There is a trend to increase the fractures in elderly population especially in developed countries, while an increase of motor vehicle accidents in developing countries. The mortality rate among male elderly patients is relatively high. The incidence of thoracolumbar spine fractures is increasing because of low-velocity falls in the elderly population. The main reasons are falls and traffic accidents. Learning the regional differences and some special forms of trauma such as extreme sports, war, and gunshot injuries will help the prevention of the thoracolumbar spine fractures.

The aim of this review to determine recommendations for classification and radiological diagnosis of thoracolumbar spine fractures. Recommendation was made through a literature review of the last 10 years. The statements created by the authors were discussed and voted on during 2 consensus meetings organized by the WFNS (World Federation Neurosurgical Societies) Spine Committee. The literature review was yielded 256 abstracts, of which 32 were chosen for full-text analysis. Thirteen papers evaluated the reliability of a classification system by our expert members and were also chosen in this guideline analysis. This literature review-based recommendation provides the classification and radiologic diagnosis in thoracolumbar spine fractures that can elucidate the management decision-making in clinical practice.

To investigate the effects of percutaneous pedicle screw internal fixation in the treatment of thoracolumbar spine fractures and its influence on patients' oxidative stress and postoperative pain. A total of 126 patients with thoracolumbar spinal fractures treated in our hospital from April 2017 to April 2021 were selected as the research subjects. According to different surgical methods, the patients were divided into minimally invasive group and open group, 63 patients in each group. Minimally invasive group was treated with percutaneous pedicle screw internal fixation, and open group was treated with open pedicle internal fixation. : The incision length and other perioperative indexes in the minimally invasive group were less than those in the open group (P<0. 05). The VAS of pain in the Minimally invasive group at 1 d, 3 d, 5 d and 7 d after operation were lower than that of the open group (P<0.05). The incidence of complications such as infection, poor incision healing, internal fixation displacement, and nerve root and spinal cord compression in the minimally invasive group at 7 d after surgery were 3.2%, which were lower than 22.2% in the open group (P<0.05). The serum Substance P (SP) and 茁-endorphin (茁-EP) levels in the two groups at 7 d after surgery were higher than those on the 1 day before operation, and the minimally invasive group were higher than the control group (P<0.05). The levels of serum glutathione peroxidase (GSH-Px) and Advanced Oxidized Protein Products (AOPP) on the 7th day after operation in the two groups were higher than those on the 1 day before operation, the minimally invasive group were higher than the open group (P<0.05). Percutaneous pedicle screw internal fixation for thoracolumbar spinal fracture can effectively control oxidative stress index and pain medium level, reduce trauma, relieve postoperative pain, reduce complications, and benefit patients' recovery. [ABSTRACT FROM AUTHOR]

This review aims to search the epidemiology and incidence rates of thoracolumbar spine fractures. A systematic review of the literature of the last 10 years gave 586 results with "incidence," and 387 results with "epidemiology," of which 39 papers were analyzed. The review results were discussed and voted in 2 consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee. Out of 39 studies, 15 studies have focused on thoracolumbar trauma, remaining 24 studies have looked at all spine trauma. Most were retrospective in nature; few were prospective and multicenter. Some studies have focused on specific injuries. The annual incidence of TL fractures is about 30/100,000 inhabitants including osteoporotic fractures. There is a trend to increase the fractures in elderly population especially in developed countries, while an increase of motor vehicle accidents in developing countries. The mortality rate among male elderly patients is relatively high. The incidence of thoracolumbar spine fractures is increasing because of low-velocity falls in the elderly population. The main reasons are falls and traffic accidents. Learning the regional differences and some special forms of trauma such as extreme sports, war, and gunshot injuries will help the prevention of the thoracolumbar spine fractures. [ABSTRACT FROM AUTHOR]

The aim of this review to determine recommendations for classification and radiological diagnosis of thoracolumbar spine fractures. Recommendation was made through a literature review of the last 10 years. The statements created by the authors were discussed and voted on during 2 consensus meetings organized by the WFNS (World Federation Neurosurgical Societies) Spine Committee. The literature review was yielded 256 abstracts, of which 32 were chosen for full-text analysis. Thirteen papers evaluated the reliability of a classification system by our expert members and were also chosen in this guideline analysis. This literature review-based recommendation provides the classification and radiologic diagnosis in thoracolumbar spine fractures that can elucidate the management decision-making in clinical practice. [ABSTRACT FROM AUTHOR]

• When fracture consolidation is confirmed, pedicle screws are no longer essential, but clear indications for screw removal following fracture consolidation have not been established. • For clinicians planning to remove screws, we recommend screw removal be performed within 12 months for restoration of segmental motion angle after confirmation of fracture consolidation. • When considering treatment strategies for TLSFs with CA ≥ 20°, a clinician should consider other surgical options such as long segment fixation and anterior reconstruction or posterolateral fusion, rather than screw removal after percutaneous-SSSF without fusion. • Screw removal can be recommended for single level TLSFs with low severity vertebra body fracture (CA < 20°) after percutaneous-SSSF without fusion. • Screw removal appears to be a safe and effective surgery for single-level low-severity vertebra body fractures following treatment using percutaneous-SSSF without fusion. Percutaneous-short segment screw fixation (SSSF) without bone fusion has proven to be a safe and effective modality for thoracolumbar spine fractures (TLSFs). When fracture consolidation is confirmed, pedicle screws are no longer essential, but clear indications for screw removal following fracture consolidation have not been established. In total, we enrolled 31 patients with TLSFs who underwent screw removal following treatment using percutaneous-SSSF without fusion. Plain radiographs, taken at different intervals, measured local kyphosis using Cobb' angle (CA), vertebra body height (VBH), and the segmental motion angle (SMA). A visual analogue scale (VAS) and the Oswestry disability index (ODI) were applied pre-screw removal and at the last follow-up. The overall mean CA deteriorated by 1.58° (p < 0.05) and the overall mean VBH decreased by 0.52 mm (p = 0.001). SMA preservation was achieved in 18 patients (58.1%) and kyphotic recurrence occurred in 4 patients (12.9%). SMA preservation was statistically significant in patients who underwent screw removal within 12 months following the primary operation (p = 0.002). Kyphotic recurrence occurred in patients with a CA ≥ 20° at injury (p < 0.001) with a median interval of 16.5 months after screw removal. No patients reported worsening pain or an increased ODI score after screw removal. Screw removal within 12 months can be recommended for restoration of SMA with improvement in clinical outcomes. Although, TLSFs with CA ≥ 20° at the time of injury can help to predict kyphotic recurrence after screw removal, the clinical outcomes are less relevant. [ABSTRACT FROM AUTHOR]

Objective: To study the effect of calcitonin on the amino terminal elongation peptide of type I collagen and type I collagen C-terminal peptide βdegradation products was applied after thoracolumbar spine fracture. Methods: 80 patients with thoracolumbar spine fracture from March 2014 to May 2016 in our hospital were randomly divided into the observation group and the control group with 40 cases in each group. They were treated with minimally invasive percutaneous pedicle screw fixation, and the control group was given routine treatment after operation, and the observation group was given salmon calcitonin treatment after operation. The bone mineral density, amino terminal elongation peptide of type I collagen, type I collagen C-terminal peptide β degradation products, visual analog pain score (VAS) score, Oswestry disability index score (ODI) score, Harris score fracture healing time and incidence of adverse reactions were compared between two groups. Results: After treatment, the bone density and Harris score in the observation group was significantly higher than those of the control group (P<0.05); while the amino terminal elongation peptide of type I collagen, type I collagen C-terminal peptide βdegradation products, VAS score and ODI score were lower than those of the control group(P<0.05); the fracture healing time in the observation group was shorter that of the control group(P<0.05); the incidence of adverse reactions (7.50%) showed no significant difference compared with that of the control group (10.00%)(P>0.05). Conclusion: The use of salmon calcitonin after thoracolumbar spine fracture can effectively improve the bone density of patients, promote the healing time of fracture factors With high safety. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of posterior internal fixation and fusion on the vertebral body parameters and trauma stress state of patients with thoracolumbar spine fracture. Methods: 60 patients with thoracolumbar spine fracture during the time of November 2016 to November 2017 were selected for the study, and they were divided into control group(anterior internal fixation and fusion group) 30 cases and observation group(posterior internal fixation and fusion group) 30 cases. Then the variation of vertebral body parameters and serum ACTH, Cor and TNF-α of two groups before and after the operation were compared. Results: At one month and six months after surgery, the vertebral body parameters of the two groups were better than those before surgery, which were better in the observation group than those of the control group(P<0.05). At one week after surgery, the level of serum ACTH, Cor of both groups were higher, which were lower in the observation group than those in the control group(P<0.05), the TNF-α level of observation group was lower in observation group than that of the control group(P<0.05). At two weeks after surgery, the serum ACTH level of observation group was much lower than those of the control group, which were even lower than those before surgery. The serum Cor and TNF-αlevels of observation group were also lower than those of the control group(P<0.05). Conclusions: The influence of posterior internal fixation and fusion for the vertebral body parameters and trauma stress state of patients with thoracolumbar spine fracture are relatively better. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to reconstruct 11 motor vehicle crashes (6 with thoracolumbar fractures and 5 without thoracolumbar fractures) and analyze the fracture mechanism, fracture predictors, and associated parameters affecting thoracolumbar spine response.Methods: Eleven frontal crashes were reconstructed with a finite element simplified vehicle model (SVM). The SVM was tuned to each case vehicle and the Total HUman Model for Safety (THUMS) Ver. 4.01 was scaled and positioned in a baseline configuration to mimic the documented precrash driver posture. The event data recorder crash pulse was applied as a boundary condition. For the 6 thoracolumbar fracture cases, 120 simulations to quantify uncertainty and response variation were performed using a Latin hypercube design of experiments (DOE) to vary seat track position, seatback angle, steering column angle, steering column position, and D-ring height. Vertebral loads and bending moments were analyzed, and lumbar spine indices (unadjusted and age-adjusted) were developed to quantify the combined loading effect. Maximum principal strain and stress data were collected in the vertebral cortical and trabecular bone. DOE data were fit to regression models to examine occupant positioning and thoracolumbar response correlations.Results: Of the 11 cases, both the vertebral compression force and bending moment progressively increased from superior to inferior vertebrae. Two thoracic spine fracture cases had higher average compression force and bending moment across all thoracic vertebral levels, compared to 9 cases without thoracic spine fractures (force: 1,200.6 vs. 640.8 N; moment: 13.7 vs. 9.2 Nm). Though there was no apparent difference in bending moment at the L1-L2 vertebrae, lumbar fracture cases exhibited higher vertebral bending moments in L3-L4 (fracture/nonfracture: 45.7 vs. 33.8 Nm). The unadjusted lumbar spine index correctly predicted thoracolumbar fracture occurrence for 9 of the 11 cases (sensitivity = 1.0; specificity = 0.6). The age-adjusted lumbar spine index correctly predicted thoracolumbar fracture occurrence for 10 of the 11 cases (sensitivity = 1.0; specificity = 0.8). The age-adjusted principal stress in the trabecular bone was an excellent indicator of fracture occurrence (sensitivity = 1.0; specificity = 1.0). A rearward seat track position and reclined seatback increased the thoracic spine bending moment by 111-329%. A more reclined seatback increased the lumbar force and bending moment by 16-165% and 67-172%, respectively.Conclusions: This study provided a computational framework for assessing thoracolumbar fractures and also quantified the effect of precrash driver posture on thoracolumbar response. Results aid in the evaluation of motor vehicle crash-induced vertebral fractures and the understanding of factors contributing to fracture risk. [ABSTRACT FROM AUTHOR]

As fraturas das regiões torácica e lombar da coluna vertebral constituem amplo espectro de diferentes tipos de lesões resultantes de mecanismos fisiopatológicos distintos. A fim de se reduzir as controvérsias existentes a respeito da conduta destas lesões é necessária a utilização de uma classificação que permita a sua correta caracterização. Neste estudo avaliamos retrospectivamente 33 pacientes portadores de fraturas tóraco-lombares com o objetivo de categorizar e avaliar os fatores relacionados a esta patologia. O mecanismo de trauma mais freqüente foi queda de altura, presente em 24 casos. Na maioria dos pacientes (57,6%) as fraturas localizaram-se na transição tóraco-lombar (T12-L1) e o quadro neurológico mais freqüente foi o déficit sensitivo-motor completo abaixo da lesão, em 45,45% dos casos. A apresentação neurológica foi mais grave nos pacientes com lesões torácicas em relação às lesões lombares (teste de Fischer, p=0,039). Uma correlação positiva foi observada entre a severidade do quadro neurológico e a gravidade da lesão segundo a classificação de Magerl (r de Pearson=0,85, pThe thoracolumbar spine fractures constitute a wide spectrum of resultant lesions, with distinct injury mechanisms. In order to reduce the controversies concerning about the management of these fractures, a universally accepted classification is necessary. In this study we evaluated retrospectively 33 patients with thoracolumbar spine fracture, with the goal of categorize and evaluate the factors related to this pathology. A complete radiological investigation, complaining of plain radiography, computed tomography and magnetic ressonance imaging, was used to classify these fractures. Fall was the more common mechanism, present in 24 cases. In 57.6% of the patients, the fractures located at thoracolumbar transition (T12-L1) and the more frequent neurological presentation was total deficit, present in 45.45%. The neurological presentation was more serious in patients with thoracic lesions regarding lumbar lesions (Fischer's test, p=0.039). A positive correlation was observed between severity of the neurological presentation and gravity of the lesion according to Magerl's classification (Pearson's method, r=0.85, p

Objective: To compare the clinical therapeutic effects of anterior decompression and posterior decompression on thoracolumbar spine fracture (TSF) complicated with spinal nerve injury (SNI). Methods: A total of 120 patients with TSF and SNI were selected and divided into a treatment group and a control group that were then treated by anterior decompression and posterior decompression respectively. The preoperative and postoperative motor scores, tactile scores, heights of injured vertebral body and Cobb's angles, as well as surgical times and intraoperative blood losses were recorded and compared. Results: Before surgeries, the motor score, tactile score, height of injured vertebral body and Cobb's angle of the treatment group were similar to those of the control group (P>0.05). After surgeries, the values of the treatment group were significantly different from those of the control group (P<0.05). The two groups also had significantly different intraoperative blood losses and surgical times (P<0.05). Conclusion: Compared with posterior decompression, anterior decompression improved spinal cord function better and relived spinal cord compression more effectively with a more reasonable mechanics of internal fixation. Although this protocol caused more blood loss, the overall therapeutic effects were more satisfactory. [ABSTRACT FROM AUTHOR]

Introduction The general consensus regarding the non-operative management of thoracolumbar (TL) spine fractures revolves around the use of thoracolumbar spine orthosis (TLSO). The efficacy of TLSO bracing remains controversial within the current literature, with several studies showing that prolonged brace use is associated with diminished lung capacity, skin breakdown, and paraspinal muscular atrophy, with no significant difference in pain and functional outcomes between patients treated with or without TLSO. Aims The aim of this study was to identify the number of braces issued over the duration of the study and understand the cost implication, added length of stay, and patient satisfaction based on a questionnaire and reflect on whether we need to change our practice on the use of TLSO. Methods Data was collected retrospectively over an 18-month period with 75 patients being initially identified for the study. A total of 42 records were included in the final study after the application of inclusion/exclusion criteria. Patient-related outcomes were recorded through a questionnaire. Results Of the patients, 60% report not receiving adequate advice regarding the duration of treatment, 43% reported that the brace interfered with their activities of daily living (ADLs), and 73% came off the brace earlier than advised, with 60% of patients reporting that they would rather be without the brace if given the option. The average increase in length of stay waiting for bracing was three days, with the estimated cost incurred being approximately £114,000. Conclusion With equivalence between treatment with or without a brace, there is a need to rethink current practice and move toward a case-by-case, patient-centered approach to minimize costs and improve patient satisfaction., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mehta et al.)

This is a retrospective study on a series of 70 patients with thoracolumbar fractures (TL), surgically treated by the in situ bending technique (ISB). Its purpose is to show the performances and limits of the ISB technique for the early correction of post-traumatic spine deformities as well as to estimate the overall outcome in this series and to discuss the indications for anterior grafting. Although the management of limbs fractures is a cleared issue today, spine fractures management is still a matter of debate. Surgical treatment progresses fast, while indications, the fixation techniques, fracture reduction options, and associated grafting are still blurry. Seventy patients with TL fractures, mean age 40.3 years (20–80) were treated by posterior fusion with a standard construct and deformity reduction by means of the ISB technique. Mean follow-up was 30.7 months (12–78). Pre- and post-operative deformity was evaluated and the relative deformity as defined by Farcy’s sagittal index (SIF) was analyzed. Thirty-eight patients underwent anterior interbody grafting. The pre-operative SIF decreased from 16.98 to 1.62° (15.36° decrease). Eighty percent of patients were normo- or hyper-corrected. The loss of correction during the follow-up occurred within the disc (SIF: −2.24°, vertebral kyphosis 0.94°, p<0.001), and was lower in patients who underwent secondary anterior grafting (−5.21° vs.–1.18°, p=0.002). Clinical outcome is good (Oswestry=29.75) and seems to be better in cases of double approach (20.71 vs. 37.,4, p=0.001). Sepsis occurred in ten cases, and two patients experienced construct dismounting. One patient had a retroperitoneal hematoma that required embolization. Seventy-one percent of operated patients went back to their previous work after surgery. Spine fractures deserve an efficient treatment. The ISB technique improves post traumatic kyphosis. This results is maintained at long term if the posterior fusion is associated with anterior grafting in cases where the correction within the disc exceeds 50% of the total correction. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the efficacy of anterior-posterior decompression on thoracolumbar spine fracture (TSF) and spinal cord injury (SCI), and assess hazard factors for postoperative deep vein thrombosis (DVT) through logistics regression., Methods: A retrospective analysis was made on 130 patients with TSF and SCI admitted to our hospital between Jan 2018 and Jan 2020. Specifically, 72 were treated with anterior decompression (experimental group) and 58 were posterior decompression (control group). The intraoperative blood loss, procedure time, hospitalization, incision size, tactile and motor scores, injured vertebral body height, Cobb angle and complications were observed. Patients were grouped based on DVT occurrence. The risk factors were assessed through logistics regression., Results: In comparison to experimental group, the intraoperative blood loss, procedure time and incision size in the control group were lower (P<0.05), while the hospitalization time was shorter (P<0.05). After treatment, the tactile and motor scores were improved 3 months after operation, and the experimental group was better (P<0.05). Additionally, injured vertebral body height and Cobb angle increased, and the experimental group was higher (P<0.05). Incidence of postoperative complications revealed no marked difference (P>0.05). Logistics regression analysis manifested that ASIA rating, diabetes, obesity and age were tied to postoperative DVT., Conclusion: Anterior decompression therapy can effectively improve the clinical outcome of patients with thoracolumbar spinal fractures and spinal cord injury on the improvement of tactile and motor functions, but posterior decompression is better than anterior surgery in terms of bleeding, incision length, operating time, and hospital stay. Surgical treatment needs to be selected according to the condition of patients. Furthermore, it was identified that ASIA rating, history of diabetes, obesity and age are risk factors affecting patients with postoperative lower extremity DVT., Competing Interests: None., (AJTR Copyright © 2022.)

Crash data from the International Center of Automotive Medicine (ICAM) database, with analytic morphomics, were used to evaluate thoracolumbar spine fractures for obese occupants in frontal crashes. Two BMI (Body Mass Index) groups (non-obese and obese) with a maximum abbreviated injury scale (MAIS) in the spine region of ≥2 (MAIS&#95;6S 2+) were categorised and compared. The fracture types were assessed based on AIS for each occupant. Univariate analyses were conducted to investigate the association between analytic morphomics measures and thoracolumbar spine fracture. The results indicate that MAIS 2+ injury occurred mainly in severe crashes with high delta-V and large intrusion. Transverse process fractures were the most common AIS 2+ fractures, followed by minor compression type fractures (≤ 20% anterior height). Compared to the non-obese occupants, the majority of obese occupants sustained transverse process fractures at lumbar vertebra with a higher incidence ratio. A statistical analysis was conducted, using vehicle, demographic, and morphomic variables, to explain the difference between transverse process fractures and vertebra body compression fractures. Transverse process fractures were related to BMI and vehicle factors (intrusion) in the obese group. In addition, morphomics related to fat distribution, muscle area, and cortical bone density are the major difference between non-obese and obese occupants.

The thoracolumbar spine fractures constitute a wide spectrum of resultant lesions, with distinct injury mechanisms. In order to reduce the controversies concerning about the management of these fractures, a universally accepted classification is necessary. In this study we evaluated retrospectively 33 patients with thoracolumbar spine fracture, with the goal of categorize and evaluate the factors related to this pathology. A complete radiological investigation, complaining of plain radiography, computed tomography and magnetic ressonance imaging, was used to classify these fractures. Fall was the more common mechanism, present in 24 cases. In 57.6% of the patients, the fractures located at thoracolumbar transition (T12-L1) and the more frequent neurological presentation was total deficit, present in 45.45%. The neurological presentation was more serious in patients with thoracic lesions regarding lumbar lesions (Fischer's test, p=0.039). A positive correlation was observed between severity of the neurological presentation and gravity of the lesion according to Magerl's classification (Pearson's method, r=0.85, p<0.001). In conclusion, thoracolumbar spine fractures are serious lesions considering the initial neurological presentation; a wide and accurate classification, as we used, is necessary to describe these injuries and may help resolve some of the controversies concerning the management of these lesions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of study was to evaluate the clinical results of early stabilization of spine fractures in polytrauma patients., Materials and Methods: Between August 2003, and May 2012, 166 polytrauma patients with thoracolumbar spine fractures were included. Patients were divided into 2 groups according to injury-to-operation time (time cut-off, 72 hours). Patients were also subdivided into 4 groups according to injury severity score (ISS), and the clinical course was evaluated., Results: Group A showed shorter hospital length of stay, intensive care unit, and ventilator days than group B. For each of these categories, the differences between the 2 groups were statistically significant (P=.004, P=.044, and P=.043). Patients with moderate to severe injury (ISS, ≥26), those who were treated with early stabilization showed shorter hospital length of stay, intensive care unit, and ventilator days than the patients with mild to moderate injury (ISS, <26), and the differences were statistically significant (P=.004, P=.006, and P=.006)., Conclusion: Polytrauma patients whose spine fractures were stabilized within 72 hours had better clinical outcomes than those with late stabilization. In addition, more severely injured patients (ISS, ≥26) benefited more from early stabilization., (Copyright © 2014 Elsevier Inc. All rights reserved.)