ABSTRACT
Background: Thoraco-lumbar spine fractures form majority of spine fractures and is an important cause of morbidity. However, comprehensive data regarding epidemiological pattern of trauma patients with spinal fractures are scarce. Many epidemiological reports about spinal fractures focus on osteoporosis as an etiologic factor. But in Indian population more important etiological factors are road traffic accidents and falls from height. Studies concerning only operatively treated patients with spinal fractures show selective and biased data that might be useful for capacity planning in hospitals or evaluating results of operative treatment, but not for epidemiological purposes. Methods: Among 86 consecutive patients with thoracic or lumbar fractures attending the out-patient department or Emergency department of Sree Gokulam Medical College, Trivandrum were enrolled in the study. All patients with fractures of the thoracic or lumbar spine were enrolled in this study.Results: Flexion distraction injuries are the second commonest unstable thoracolumbar spine injuries.Conclusions: This study is a prospective cohort study of the epidemiological aspects and pattern of injury and treatment in thoraco-lumbar spine fractures at a tertiary care referral center. A total of 86 patients were enrolled in the study. The most common fracture pattern seen in this study was compression fractures (24.4%) which are stable. This was followed by stable burst fractures (23.2%, unstable burst fractures (18.6%), translational injuries (fracture-dislocations) (16.3%), flexion-distraction injuries (13.9%) and chance fractures (3.5%).
ABSTRACT
Introduction: Thoraco-lumbar spine fractures form majorityof spine fractures and is an important cause of morbidity.However, comprehensive data regarding epidemiologicalpattern of trauma patients with spinal fractures are scarce.Many epidemiological reports about spinal fractures focus onosteoporosis as an etiologic factor. But in Indian populationmore important etiological factors are road traffic accidentsand falls from height. Studies concerning only operativelytreated patients with spinal fractures show selective andbiased data that might be useful for capacity planning inhospitals or evaluating results of operative treatment, but notfor epidemiological purposesMaterial and Methods: 86 consecutive patients with thoracicor lumbar fractures attending the out-patient department orEmergency department of Sree Gokulam Medical CollegeHospital, Trivandrum were enrolled in the study. All patientswith fractures of the thoracic or lumbar spine were enrolledin this study.Result: Distribution of fracture pattern in thoracolumbarspine injuries were studied. And the methods to prevent thosefractures are listed in this study.Conclusion: This study is a prospective cohort study of theepidemiological aspects and pattern of injury and treatment inthoraco-lumbar spine fractures at a tertiary care referral center.A total of 86 patients were enrolled in the study.The mostcommon fracture pattern seen in this study was compressionfractures (24.4%) which are stable. This was followed bystable burst fractures (23.2%, unstable burst fractures (18.6%),translational injuries (fracture-dislocations)(16.3%), flexiondistraction injuries(13.9%) and chance fractures(3.5%).
ABSTRACT
STUDY DESIGN: A retrospective study. OBJECTIVES: We assessed the intraobserver and interobserver reliability of TLICS classification in the thoracolumbar injuries, which had been evaluated in our hospital. It was compared with that of the older, McAfee classification and discussed for clinical validation. SUMMARY OF LITERATURE REVIEW: Among the numerous literatures regarding the thoracolumbar injury, there is no consensus on the most useful classification, and there is nothing comparing the McAfee classification with the TLICS classification. MATERIALS AND METHODS: Among the 230 patients that were treated with conservative care or operation from January 1, 2005 to January 1, 2010 in our hospital, 185 patients with initial CT and MRI images were assessed. Five orthopedic surgeons reviewed histories, plain film, CT and MRI of the 185 thoracolumbar injury cases, respectively. Each case was classified and scored according to the McAfee classification and the TLICS classification. The case assessment was recorded and the orthopedic surgeons repeated the assessment 1 month later. Intraobserver and interobserver reliability were assessed by statistical analysis. The actual management of each case was compared with the treatment recommended by TLICS classification to calculate the validity of the indexes. RESULTS: Intraobserver and interobserver reliability in TLICS were higher than those in the McAfee classification. Agreement of the TLICS classification for treatment recommendation was 81.7%, comparing with the actual management of previous McAfee classification. Validity indexes were satisfactory in therapeutic decision making, especially specificity. CONCLUSIONS: TLICS classification has a relative high K-value, when compared with that of the McAfee classification for intraobserver and interobserver reliability. Through clinical studies, including prospective observational analysis, TLICS classification can be applied and adjusted more adequately.