Journal of Isfahan Medical School

Journal of Isfahan Medical School

Outcomes of Pediatric Thoracic and Lumbar Spine Fracture: A Retrospective Analysis of 79 Patients

Document Type : Original Article(s)

Authors
Ahmad Piriaei 1
Ali Abdoli 1
Mohammadreza Saatian 1
Meysam Alimohammadi 2
Mohammad Ali Seif-Rabiei 3
1 Assistant Professor, Department of Neurosurgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2 Assistant Professor, Department of Neurosurgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
3 Associate Professor, Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
10.48305/jims.v41.i720.0364
Abstract
Background: This study aimed to investigate the radiological (deformity) and clinical outcomes following two types of medical or surgical treatments in children with spinal trauma.
Methods: This study was conducted as a retrospective cohort study containing patients from a 13 years period (2007-2019). Patients under 18 years of age who underwent medical or surgical treatment in one trauma center due to spine trauma in the thoracic and/or lumbar parts were evaluated and followed up. Demographic characteristics, mechanism of injury, clinical, radiological conditions and type of treatment were extracted from medical records. At the time of follow-up, after evaluating the neurological status and spine imaging, the primary and secondary characteristics of the patients were compared.
Findings: A total of 79 patients with an average age of 14.36 ± 3.5 years were included in this study and followed up for an average of 36 months. The fracture was single level in 42 patients and the most common form was compression. Primary neurological deficit was present in 14% of patients, of which 2.6% had incomplete deficit and the rest had paraplegic manifestations. Thirty eight patients were treated surgically. More than one third of patients with neurological deficit at the initial examination, finally had neurological improvement and regained independence in performing personal activities. Finally 2.53% of patients had scoliosis at the time of follow-up. Scoliosis was more common in patients who underwent surgery. Multiple level fractures were associated with lower amounts of thoracic kyphosis.
Conclusion: It appears that using the Thoracolumbar Injury Classification and Severity Scale (TLICS) with a more surgical threshold for decision making would be benefical.
Keywords
Pediatrics
Spinal fractures
Patient outcome assessment
Neurologic manifestations
Scoliosis

Subjects

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Journal of Isfahan Medical School
Volume 41, Issue 720
4th Week,July
July and August 2023
Pages 364-372

  • Receive Date 16 February 2023
  • Revise Date 10 June 2023
  • Accept Date 10 June 2023