medigraphic.com
ISSN 2992-7749 (Electronic)
ISSN 2992-7897 (Print)
Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2023, Number 1

<< Back Next >>

Cir Columna 2023; 1 (1)

Surgical management in adult patients with thoracolumbar fracture. Systematic review

Vargas DTA, OConnor-Córdova MA, Canal-Zárate P

Language: Spanish
References: 15
Page: 24-31
PDF size: 181.98 Kb.


ABSTRACT

The most common fractures of the spine are associated with the thoracolumbar joint. The goals of thoracolumbar fracture treatment are to promote early mobilization and rehabilitation, restoring mechanical stability to the fracture and inducing neurological recovery, allowing patients to return to work. However, there are still controversies about treatment methods. The neurological lesion must be identified to determine the appropriate treatment. The mechanical stability of the fracture should also be assessed using imaging studies to assess for soft tissue injuries involving neurological structures or the posterior ligamentous complex. Based on these physical examinations and images, the stability of the fracture is evaluated, and it is determined whether to opt for a conservative or surgical treatment. Instrument developments have generated more interest in mobile segment-preserving surgical treatment without fusion and in instrumentation through a minimally invasive approach in recent years. There is still controversy about the use of these techniques because there is still no verified evidence. However, the morbidity of patients can be decreased, and good clinical and radiographic results can be achieved if recent operative treatments are used carefully considering the fracture pattern and the severity of the injury.


REFERENCES

  1. Koosha M, Nayeb Aghaei H, Khayat Kashani HR, Paybast S. Functional outcome of surgical versus conservative therapy in patients with traumatic thoracolumbar fractures and thoracolumbar injury classification and severity score of 4; a non-randomized clinical trial. Bull Emerg Trauma. 2020; 8: 89-97.

  2. Verlaan JJ, Diekerhof CH, Buskens E, Van Der Tweel I, Verbout AJ, Dhert WJA, et al. Surgical treatment of traumatic fractures of the thoracic and lumbar spine: a systematic review of the literature on techniques, complications, and outcome. Spine (Phila Pa 1976). 2004; 29: 803-814.

  3. Muratore M, Allasia S, Viglierchio P, Abbate M, Aleotti S, Masse A, et al. Surgical treatment of traumatic thoracolumbar fractures: a retrospective review of 101 cases. Musculoskelet Surg. 2021; 105: 49-59.

  4. Kim BG, Dan JM, Shin DE. Treatment of thoracolumbar fracture. Asian Spine J. 2015; 9: 133-146.

  5. Alpantaki K, Bano A, Pasku D, Mavrogenis AF, Papagelopoulos PJ, Sapkas GS, et al. Thoracolumbar burst fractures: a systematic review of management. Orthopedics. 2010; 33: 422-429.

  6. Joaquim AF, Patel AA, Schroeder GD, Vaccaro AR. A simplified treatment algorithm for treating thoracic and lumbar spine trauma. J Spinal Cord Med. 2019; 42: 416-422.

  7. Pneumaticos SG, Triantafyllopoulos GK, Giannoudis PV. Advances made in the treatment of thoracolumbar fractures: Current trends and future directions. Injury. 2013; 44: 703-712.

  8. Cook E, Scantlebury A, Booth A, Turner E, Ranganathan A, Khan A, et al. Surgery versus conservative management of stable thoracolumbar fracture: the presto feasibility RCT. Health Technol Assess. 2021; 25: 1-125.

  9. Siebenga J, Leferink VJM, Segers MJM, Elzinga MJ, Bakker FC, Haarman HJTM, et al. Treatment of traumatic thoracolumbar spine fractures: A multicenter prospective randomized study of operative versus nonsurgical treatment. Spine (Phila Pa 1976). 2006; 31: 2881-2890.

  10. Vila-Canet G, García de Frutos A, Covaro A, Ubierna MT, Caceres E. Thoracolumbar fractures without neurological impairment: A review of diagnosis and treatment. EFORT Open Rev. 2016; 1: 332-338.

  11. Park CJ, Kim SK, Lee TM, Park ET. Clinical relevance and validity of TLICS system for thoracolumbar spine injury. Sci Rep. 2020; 10: 19494.

  12. Dai LY. Principles of management of thoracolumbar fractures. Orthop Surg. 2012; 4: 67-70.

  13. Wood KB, Li W, Lebl DR, Ploumis A. Management of thoracolumbar spine fractures. Spine J. 2014; 14: 145-164.

  14. Zhu C, Wang B, Yin J, Liu XH. A comparison of three different surgery approaches and methods for neurologically intact thoracolumbar fractures: a retrospective study. J Orthop Surg Res. 2021; 16: 306.

  15. Koreckij T, Park DK, Fischgrund J. Minimally invasive spine surgery in the treatment of thoracolumbar and lumbar spine trauma. Neurosurg Focus. 2014; 37: E11.




2020     |     www.medigraphic.com