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Management of thoracolumbar spine trauma: An overview

Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Controversies exist regarding the appropriate radiological investigations, the indications for surgical management and the timing, approach and type of surgery. This revie...

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Autores principales: Rajasekaran, S, Kanna, Rishi Mugesh, Shetty, Ajoy Prasad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292328/
https://www.ncbi.nlm.nih.gov/pubmed/25593358
http://dx.doi.org/10.4103/0019-5413.143914
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author Rajasekaran, S
Kanna, Rishi Mugesh
Shetty, Ajoy Prasad
author_facet Rajasekaran, S
Kanna, Rishi Mugesh
Shetty, Ajoy Prasad
author_sort Rajasekaran, S
collection PubMed
description Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Controversies exist regarding the appropriate radiological investigations, the indications for surgical management and the timing, approach and type of surgery. This review provides an overview of the epidemiology, biomechanical principles, radiological and clinical evaluation, classification and management principles. Literature review of all relevant articles published in PubMed covering thoracolumbar spine fractures with or without neurologic deficit was performed. The search terms used were thoracolumbar, thoracic, lumbar, fracture, trauma and management. All relevant articles and abstracts covering thoracolumbar spine fractures with and without neurologic deficit were reviewed. Biomechanically the thoracolumbar spine is predisposed to a higher incidence of spinal injuries. Computed tomography provides adequate bony detail for assessing spinal stability while magnetic resonance imaging shows injuries to soft tissues (posterior ligamentous complex [PLC]) and neurological structures. Different classification systems exist and the most recent is the AO spine knowledge forum classification of thoracolumbar trauma. Treatment includes both nonoperative and operative methods and selected based on the degree of bony injury, neurological involvement, presence of associated injuries and the integrity of the PLC. Significant advances in imaging have helped in the better understanding of thoracolumbar fractures, including information on canal morphology and injury to soft tissue structures. The ideal classification that is simple, comprehensive and guides management is still elusive. Involvement of three columns, progressive neurological deficit, significant kyphosis and canal compromise with neurological deficit are accepted indications for surgical stabilization through anterior, posterior or combined approaches.
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spelling pubmed-42923282015-01-15 Management of thoracolumbar spine trauma: An overview Rajasekaran, S Kanna, Rishi Mugesh Shetty, Ajoy Prasad Indian J Orthop Symposium-ICL-2014 Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Controversies exist regarding the appropriate radiological investigations, the indications for surgical management and the timing, approach and type of surgery. This review provides an overview of the epidemiology, biomechanical principles, radiological and clinical evaluation, classification and management principles. Literature review of all relevant articles published in PubMed covering thoracolumbar spine fractures with or without neurologic deficit was performed. The search terms used were thoracolumbar, thoracic, lumbar, fracture, trauma and management. All relevant articles and abstracts covering thoracolumbar spine fractures with and without neurologic deficit were reviewed. Biomechanically the thoracolumbar spine is predisposed to a higher incidence of spinal injuries. Computed tomography provides adequate bony detail for assessing spinal stability while magnetic resonance imaging shows injuries to soft tissues (posterior ligamentous complex [PLC]) and neurological structures. Different classification systems exist and the most recent is the AO spine knowledge forum classification of thoracolumbar trauma. Treatment includes both nonoperative and operative methods and selected based on the degree of bony injury, neurological involvement, presence of associated injuries and the integrity of the PLC. Significant advances in imaging have helped in the better understanding of thoracolumbar fractures, including information on canal morphology and injury to soft tissue structures. The ideal classification that is simple, comprehensive and guides management is still elusive. Involvement of three columns, progressive neurological deficit, significant kyphosis and canal compromise with neurological deficit are accepted indications for surgical stabilization through anterior, posterior or combined approaches. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4292328/ /pubmed/25593358 http://dx.doi.org/10.4103/0019-5413.143914 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Symposium-ICL-2014
Rajasekaran, S
Kanna, Rishi Mugesh
Shetty, Ajoy Prasad
Management of thoracolumbar spine trauma: An overview
title Management of thoracolumbar spine trauma: An overview
title_full Management of thoracolumbar spine trauma: An overview
title_fullStr Management of thoracolumbar spine trauma: An overview
title_full_unstemmed Management of thoracolumbar spine trauma: An overview
title_short Management of thoracolumbar spine trauma: An overview
title_sort management of thoracolumbar spine trauma: an overview
topic Symposium-ICL-2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292328/
https://www.ncbi.nlm.nih.gov/pubmed/25593358
http://dx.doi.org/10.4103/0019-5413.143914
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