Clinical and radiological outcome of non-surgical management of thoracic and lumbar spinal fracture-dislocations - a historical analysis in the era of modern spinal surgery.

The Journal of Spinal Cord Medicine
Andrei F JoaquimAlexander R Vaccaro

Abstract

Context: It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment.Objective: Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries.Methods: An extensive manual search of articles was performed in the Pubmed Database. We included articles that reported the clinical and/ or the radiological outcome of non-surgical management of thoracic and/ or lumbar spinal fracture-dislocations.Results: Three well described retrospective studies where fracture-dislocations of the thoracolumbar spine were managed non-surgically were included. Non-surgical management typically consisted in postural reduction and prolonged bed rest (about 10-13 weeks on average). Residual deformity was common, and some studies reported a high rate of post treatment pain syndromes. Some studies reported surgery for gibbus deformity after conservative treatment or persistent instability requiring further bed rest. Neurological deter...Continue Reading

References

Nov 1, 1974·The Journal of Bone and Joint Surgery. British Volume·J Lewis, B McKibbin
Aug 24, 2013·Spine·Alexander R VaccaroUNKNOWN AOSpine Spinal Cord Injury & Trauma Knowledge Forum
Jan 2, 2014·Journal of Craniovertebral Junction and Spine·Andrei F Joaquim, Alpesh A Patel

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Citations

Jul 7, 2018·Spinal Cord Series and Cases·Andrei F JoaquimAlexander R Vaccaro
Aug 26, 2020·Spinal Cord Series and Cases·Sami I AlEissaMohammed T AlZahrani

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