Results of Operative Treatment in Fracture-Dislocations of Thoracic and Lumbar Spine / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To analyze the complications and improvement of neurologic injury after operative treatment in the fracture-dislocations of thoracic and lumbar spine in long-term follow-up. MATERIALS AND METHODS: A retrospective review of 39 patients, who were operated on for fracture-dislocations in thoracic and lumbar spine from May 1982 to May 1995 was conducted. We evaluated the result with Denis classification for type of fracture-dislocations and with Frankel classification for the neurologic injury. Average levels of fusion were 4.56 segments, ranging from 2 to 7 segments. RESULTS: According to the Frankel classification, the most common neurologic status at initial presentation was grade A in 28 cases (71.8%) and cases with complete paraplegia showed no improvement in long-term follow-up at all. Six other cases with incomplete paraplegia showed average neurologic improvement of 1.5 grade. Ischial sore was most common (13 cases) complication. CONCLUSIONS: Fracture-dislocations showed a higher incidence of neurologic injury than other spine fractures. Complete paraplegia was most common with no neurologic improvement in longterm follow-up. Incomplete paraplegia showed neurologic improvement. The cases of complete paraplegia had more complications than cases of incomplete paraplegia. The authors think that the postoperative care of complete paraplegia is important.