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Morphological features of thoracolumbar burst fractures associated with neurological outcome in thoracolumbar traumatic spinal cord injury

Résumé Purpose To identify specifc morphological characteristics in thoracolumbar burst fractures associated with neurological Methods We retrospectively analyzed the clinical and radiological (CT scan morphological characteristics) data of 25 consecutive patients admitted for TSCI secondary to a burst fracture at levels from T11 to L2 between 2010 and 2017 in single level-1 trauma center. We included severe TSCI, defned as American Spinal Injury Association Impairment Scale (AIS) grade A, B or C. Results Among the 25 patients with severe TSCI, 14 were AIS A, 5 were AIS B, and 6 were AIS C upon initial preopera- tive neurological evaluation. The AIS grade and the burden of associated injuries (Injury Severity Score, ISS) were the only clinical factors signifcantly associated with poor neurological recovery. The trauma level of energy was not associated with neurological outcome. Several fractures parameters were independently related to neurological recovery: the postero-inferior corner translation, presence of retropulsed fragment comminution and complete lamina fracture. The magnitude of sagittal kyphosis angle, vertebral kyphosis index and vertebral body comminution were not associated with the neurological outcome. Conclusions Morphological features of the bony structures involving the spinal canal in thoracolumbar burst fractures with severe TSCI are associated with the chronic neurological outcome and could provide more insight than the AIS clinical grading. The fracture pattern may better refect the actual level of energy transferred to the spinal cord than distinguishing between low- and high-energy trauma.
Julien Goulet, Andréane Richard‐Denis, Yvan Petit, Lucien Diotalevi, Jean-Marc Mac-Thiong
Titre de revue/journal, volume et numéroEuropean Spine Journal
Langue de la publication et/ou de traductionAnglais (langue d’origine)
Année de parution2020
Pays Québec, Canada.
Institutions affiliéesUniversité de Montréal, Hopital Sacré Coeur, Ecole de technologie supérieure
Lien vers la publicationVoir document ci-dessous
Type d’accès à la publicationGratuit
Mots clésBurst fracture · Thoracolumbar trauma · Neurological outcome · Spinal cord injury
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Précédent Impaired transmission in the corticospinal tract and gait disability in spinal cord injured persons
Prochain Patterns and predictors of functional recovery from the subacute to the chronic phase following a traumatic spinal cord injury: a prospective study
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