Treatment of traumatic thoracolumbar spine fractures:: A multicenter prospective randomized study of operative versus nonsurgical treatment
Treatment of traumatic thoracolumbar spine fractures:: A multicenter prospective randomized study of operative versus nonsurgical treatment
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DOI：
10.1097/01.brs.0000247804.91869.1e
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发表时间：
2006-12-01
期刊：
影响因子：
3
通讯作者：
Patka, Peter
中科院分区：
文献类型：
--
作者：
Siebenga, Jan;Leferink, Vincent J. M.;Patka, Peter
研究设计.多中心前瞻性随机试验。为了验证以下假设，即与非手术治疗的胸腰椎骨折相比，采用短节段后路稳定治疗无神经功能缺损的胸腰椎AO A型脊柱骨折将显示出改善的影像学结果和至少相同的功能结果。背景资料总结。关于无神经功能缺损的胸腰椎A型骨折的理想治疗方法存在不同的观点。手术和非手术方法都是可取的。患者随机接受手术或非手术治疗。数据采集涉及人口统计学、骨折分类、影像学评价和功能结局。非手术治疗16例，手术治疗18例。平均4.3年后，32例（94%）患者完成了随访。随访结束时，手术治疗组的局部和区域后凸畸形明显较少。所有功能结局评分（VAS疼痛、VAS脊柱评分和RMDQ-24）均显示手术组的结果明显更好。手术治疗组的患者返回原工作岗位的比例明显高于手术治疗组。无神经功能缺损的A3型胸腰椎骨折患者应采用短节段后路稳定术治疗。
Study Design. Multicenter prospective randomized trial.Objective. To test the hypotheses that thoracolumbar AO Type A spine fractures without neurologic deficit, managed with short-segment posterior stabilization will show an improved radiographic outcome and at least the same functional outcome as compared with nonsurgically treated thoracolumbar fractures.Summary of Background Data. There are various opinions regarding the ideal management of thoracolumbar Type A spine fractures without neurologic deficit. Both operative and nonsurgical approaches are advocated.Methods. Patients were randomized for operative or nonsurgical treatment. Data sampling involved demographics, fracture classifications, radiographic evaluation, and functional outcome.Results. Sixteen patients received nonsurgical therapy, and 18 received surgical treatment. Follow-up was completed for 32 (94%) of the patients after a mean of 4.3 years. At the end of follow-up, both local and regional kyphotic deformity was significantly less in the operatively treated group. All functional outcome scores (VAS Pain, VAS Spine Score, and RMDQ-24) showed significantly better results in the operative group. The percentage of patients returning to their original jobs was found to be significantly higher in the operative treated group.Conclusions. Patients with a Type A3 thoracolumbar spine fracture without neurologic deficit should be treated by short-segment posterior stabilization.