A Clinical Analysis of the Patients with Thoracolumbar Vertebral Junction Fracture

ABSTRACT

To clarify the prognostic factors influencing clinical outcome, the authors retrospectively analyzed 50 cases of thoracolumbar vertebral junction fracture treated at our hospital between September 1989 and October 1992. The age of the patients ranged from 23 to 75 years(median 49 years) and the male-to-female ratio was 3317. Falling was the major mode of injury(m=27). The kyphotic angle between fractured vertebrae and the ratio of neural canal encroachment was measured in a simple X-ray and a computed tomography(CT) of the thoracic spine. An ANOVA test was performed to evaluate the predicting factors to determine the final outcome. The kyphotic angle and loss of height of vertebral body were not significantly correlated with the neurological status of the patients. However, the ratio of the compromised area of the neural canal was closely correlated with the neurological outcome(p value<0.05). The worst prognosis was found in patients with fracture-dislocation. In conclusion, it is suggested that early surgical intervention must be considered in the neurologically compromised patients whose CT demonstrates neural canal encroachment by bony fragments.