Reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deterioration
Abstract Background The presence of vertebral fractures affect variations in the termination level of conus medullaris (TLCM) and alter neurological findings. However, few studies have examined association between vertebral fractures, TLCM, and neurological findings. Thus, we herein studied the numb...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-017-0649-1 |
| _version_ | 1798034122721984512 |
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| author | Kazuhiro Fujimoto Tsukasa Kanchiku Yasuaki Imajo Hidenori Suzuki Norihiro Nishida Masahiro Funaba Toshihiko Taguchi |
| author_facet | Kazuhiro Fujimoto Tsukasa Kanchiku Yasuaki Imajo Hidenori Suzuki Norihiro Nishida Masahiro Funaba Toshihiko Taguchi |
| author_sort | Kazuhiro Fujimoto |
| collection | DOAJ |
| description | Abstract Background The presence of vertebral fractures affect variations in the termination level of conus medullaris (TLCM) and alter neurological findings. However, few studies have examined association between vertebral fractures, TLCM, and neurological findings. Thus, we herein studied the number and severity of vertebral fractures, TLCM, and neurological findings to clarify the mechanism of neurological deterioration in patients with vertebral fractures. Methods A total of 411 patients who underwent computed tomographic myelography were classified into those with (group F, n = 73) and those without vertebral fractures (group C, n = 338). We assessed correlations between TLCM and age, height, and gender in group C, differences in TLCM between groups F and C, and correlations between TLCM, and the number and severity score of fractures. Neurological evaluations were performed for the patellar tendon reflex (PTR), muscle weakness, sensory disturbance, and bladder contraction disorders. Results TLCM was most commonly located at the L1 vertebral body in group C and did not significantly differ with age, height, or gender. TLCM was most commonly located at L2 vertebral body in group F. TLCM was more caudally located in group F (P < 0.01). Additionally, there was a significant difference between TLCM and number of fractures, and the severity score of fractures (both P < 0.01). Twenty-three patients showed neurological deterioration by vertebral fractures. Some patients with T12 vertebral fracture showed hyperreflexia of PTR. Serious bladder contraction disorders were seen in patients with compression at close range of TLCM. Conclusion We confirmed that vertebral fractures altered location of the TLCM, thus altering potential neurological symptoms. Moreover, there were correlations of the TLCM with the number and severity score of vertebral fractures. Spine surgeons should be cognizant of the relationship between TLCM, level of compressive lesion, and neurological findings to avoid the wrong level in spine surgery and unexpected neurological deteriorations after surgery. |
| first_indexed | 2024-04-11T20:39:55Z |
| format | Article |
| id | doaj.art-7c03ca611d5c46248864a6ef7343ff46 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T20:39:55Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-7c03ca611d5c46248864a6ef7343ff462022-12-22T04:04:14ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2017-10-011211610.1186/s13018-017-0649-1Reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deteriorationKazuhiro Fujimoto0Tsukasa Kanchiku1Yasuaki Imajo2Hidenori Suzuki3Norihiro Nishida4Masahiro Funaba5Toshihiko Taguchi6Department of Orthopaedic Surgery, Yamaguchi University Graduate School of MedicineDepartment of Orthopaedic Surgery, Yamaguchi University Graduate School of MedicineDepartment of Orthopaedic Surgery, Yamaguchi University Graduate School of MedicineDepartment of Orthopaedic Surgery, Yamaguchi University Graduate School of MedicineDepartment of Orthopaedic Surgery, Yamaguchi University Graduate School of MedicineDepartment of Orthopaedic Surgery, Yamaguchi University Graduate School of MedicineDepartment of Orthopaedic Surgery, Yamaguchi University Graduate School of MedicineAbstract Background The presence of vertebral fractures affect variations in the termination level of conus medullaris (TLCM) and alter neurological findings. However, few studies have examined association between vertebral fractures, TLCM, and neurological findings. Thus, we herein studied the number and severity of vertebral fractures, TLCM, and neurological findings to clarify the mechanism of neurological deterioration in patients with vertebral fractures. Methods A total of 411 patients who underwent computed tomographic myelography were classified into those with (group F, n = 73) and those without vertebral fractures (group C, n = 338). We assessed correlations between TLCM and age, height, and gender in group C, differences in TLCM between groups F and C, and correlations between TLCM, and the number and severity score of fractures. Neurological evaluations were performed for the patellar tendon reflex (PTR), muscle weakness, sensory disturbance, and bladder contraction disorders. Results TLCM was most commonly located at the L1 vertebral body in group C and did not significantly differ with age, height, or gender. TLCM was most commonly located at L2 vertebral body in group F. TLCM was more caudally located in group F (P < 0.01). Additionally, there was a significant difference between TLCM and number of fractures, and the severity score of fractures (both P < 0.01). Twenty-three patients showed neurological deterioration by vertebral fractures. Some patients with T12 vertebral fracture showed hyperreflexia of PTR. Serious bladder contraction disorders were seen in patients with compression at close range of TLCM. Conclusion We confirmed that vertebral fractures altered location of the TLCM, thus altering potential neurological symptoms. Moreover, there were correlations of the TLCM with the number and severity score of vertebral fractures. Spine surgeons should be cognizant of the relationship between TLCM, level of compressive lesion, and neurological findings to avoid the wrong level in spine surgery and unexpected neurological deteriorations after surgery.http://link.springer.com/article/10.1186/s13018-017-0649-1Spinal fracturesOsteoporotic fracturesThoracic vertebraeLumbar vertebraeConus medullarisSpinal cord compression |
| spellingShingle | Kazuhiro Fujimoto Tsukasa Kanchiku Yasuaki Imajo Hidenori Suzuki Norihiro Nishida Masahiro Funaba Toshihiko Taguchi Reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deterioration Journal of Orthopaedic Surgery and Research Spinal fractures Osteoporotic fractures Thoracic vertebrae Lumbar vertebrae Conus medullaris Spinal cord compression |
| title | Reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deterioration |
| title_full | Reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deterioration |
| title_fullStr | Reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deterioration |
| title_full_unstemmed | Reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deterioration |
| title_short | Reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deterioration |
| title_sort | reduction of vertebral height with fragility vertebral fractures can induce variety of neurological deterioration |
| topic | Spinal fractures Osteoporotic fractures Thoracic vertebrae Lumbar vertebrae Conus medullaris Spinal cord compression |
| url | http://link.springer.com/article/10.1186/s13018-017-0649-1 |
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