Functional Outcomes of Thoracolumbar Junction Spine Fractures

Authors

  • Bradford A. Wall, M.D. University of Kansas School of Medicine-Wichita, KS Department of Orthopaedics
  • Alan Moskowitz, M.D. University of Kansas School of Medicine-Wichita, KS Department of Orthopaedics; Kansas Orthopaedic Center, PA, Wichita, KS
  • M. Camden Whitaker, M.D. University of Kansas School of Medicine-Wichita, KS Department of Orthopaedics; Orthopaedic & Sports Medicine at Cypress, Wichita, KS
  • Teresa L. Jones, MPH University of Kansas School of Medicine-Wichita, KS Department of Orthopaedics; Kansas Orthopaedic Center, PA, Wichita, KS
  • Ryan M. Stuckey, M.D. University of Kansas School of Medicine-Wichita, KS Department of Orthopaedics
  • Catherine L. Carr-Maben, B.S., L.R.T. (R)(CT) Kansas Orthopaedic Center, PA, Wichita, KS
  • Alexander CM. Chong, MSAE, MSME University of Kansas School of Medicine-Wichita, KS Department of Orthopaedics; Via Christi Health, Department of Graduate Medical Education, Wichita, KS

DOI:

https://doi.org/10.17161/kjm.v10i2.8649

Keywords:

spinal fractures, treatment outcomes, kyphosis, kyphotic curvature

Abstract

Introduction. Few studies have evaluated the functional
outcomes of traumatic thoracic and lumbar vertebral body
fractures. This study evaluated the functional and clinical
outcomes of patients, who sustained a fracture to the
thoracolumbar area of the spine (T10 to L2 region), with
≥ 25° kyphosis versus those with less kyphotic curvature.


Methods. The trauma registry records of two level 1 trauma
centers using ICD-9 codes for fracture to the thoracolumbar
juncture (T10 to L2 region) were reviewed. Kyphosis angle
was measured on the standing lateral thoracolumbar (T1 -
L5) radiograph at initial trauma and at clinical follow-up.
Functional outcome questionnaires, including the Oswestry
Disability Questionnaire (ODQ), the Roland Morris Disability
Questionnaire (RMDQ), and the Nottingham Health Profile
(NHP), were evaluated at clinical follow-up. Work status
and medication used after trauma also were recorded.


Results. A total of 38 patients met the inclusive criteria. Seventeen
patients (45%) had ≥ 25° kyphosis and 21 patients (55%)
had < 25° kyphosis at follow-up. These two groups were similar
based on sex and age. Based on the ODQ Score, the RMDQ
Score, and the NHP, no statistically significant differences
were detected between the two groups in regards to energy,
pain, mobility, emotional reaction, social isolation, and sleep.


Conclusions. Patients who sustained a fracture to the thoracolumbar
area of the spine with ≥ 25° kyphosis do not
report worse clinical outcomes. When using the kyphosis
angle as an indication for surgery, it should be used with
caution and not exclusively. KS J Med 2017;10(2):30-34.

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Published

2019-01-14

Issue

Section

Original Research