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KMID : 0388720090160010001
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Journal of Korean Society of Spine Surgery
2009 Volume.16 No. 1 p.1 ~ p.7
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The Analysis of Prognostic Factors on Unstable Burst Fracture on the Thoracolumbar Spine
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Lee Kyu-Yeol
Lee Myung-Jin
Sohn Sung-Keun
Kim Hyeon-Jun
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Abstract
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Study Design: A retrospective clinical and radiological analysis
Objectives:To determine the relationship between the classifications of unstable burst fractures on the thoracolumbar region, radiologic studies, signal change area on MRA and analysis of the prognostic factors.
Summary of Literature Review: MRI is the first imaging modality that visualizes the extent of spinal cord derangement directly and it has the potential to provide an accurate diagnosis and prognosis.
Materials and Methods: From March 1998 to September 2006, 39 patients who were eligible for a follow up of more than 1 year with an unstable burst fracture on the thoracolumbar region were studied. With these cases, The size of the bone fragment at the initial injury, signal change area on MRI, time to surgery, reduction rate of the bone fragments, recovery of the posterior curvature of the vertebrae and height of the vertebral body were analyzed.
Results:The mean fracture size rate, average time to surgery, reduction rate of bone fragment and the recovery rate of the height of the vertebral body was 46.1±12.8%, 17±4.5 hours, 35.2±10.1%, and 57.9±17.4%, respectively. The data shows that the time elapsed until surgery had no relationship with the prognosis (P=0.317). Injuries with broad signal changes on MRI were not associated with the reduction rate of bone fragments, recovery of posterior curvature of the vertebrae and the height of the vertebral body.
Conclusions: In unstable burst fractures of the thoracolumbar region, although a comparison of the prognostic factors on simple X-ray film had no significance, it still has significant meaning when correlated with the signals on MRI.
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KEYWORD
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Thoracolumbar spine, Unstable burst fracture, Prognostic factors
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