Fractures of Thoracic and Lumbar Spine; Treatment and Follow Up

The number of posttraumatic spinal fractures is constantly growing. About 15-20% of patients injury need surgery after injury, as result of spinal instability or canal stenosis often leading to neurological complications. In 1987-97 56 patients (6 female and 50 male) were treated following serious spine trauma with fractures. The age of the patients was 19-61 years. Car accidents were the most common cause of trauma affecting 30 patients (53%), falls from heights affecting 26 patients (47%). Multiple injuries were diagnosed in 24 patients (43%). More than one vertebra was fractured in 15 patients (27%). In 9 cases (16%) surgery was performed within 24 hours of the accident, in 22 (39%) within 72 hours and in 25 patients (45%) after 72 hours, in some cases even several weeks after the trauma. 20 patients (36%) required spinal decompression after the accident. The fracture in one case was located in the thoracic section, in 17 patients in Th11-L2 and in 2 patients in L3-L5 section. In 4 cases reconstruction of the meninx was performed. 48 patients were treated by stabilisation using Harrington rods; in 5 patients Kluger stabilisers were used, in the remaining 3 patients stabilization was carried out by wire loop. In all cases frozen and radiation-sterilized bone allografts were applied. Results were evaluated 2-8 years after surgery using X-rays, CT-pictures and direct examination. In 25 patients (45%) results were found to be good, in 23 patients (41%) mediocre and in 8 patients (14%) results were unsatisfactory.