Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture
Abstract Background There is a controversy about the management of patients with a thoracolumbar burst fracture. Despite the success of the conservative treatment in most of the cases, some patients failed the conservative treatment. The present study aimed to evaluate risk factors for the need for...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-02044-3 |
| _version_ | 1818015391850430464 |
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| author | Ehsan Alimohammadi Seyed Reza Bagheri Paniz Ahadi Sahar Cheshmehkaboodi Homa Hadidi Shokofeh Maleki Alireza Abdi |
| author_facet | Ehsan Alimohammadi Seyed Reza Bagheri Paniz Ahadi Sahar Cheshmehkaboodi Homa Hadidi Shokofeh Maleki Alireza Abdi |
| author_sort | Ehsan Alimohammadi |
| collection | DOAJ |
| description | Abstract Background There is a controversy about the management of patients with a thoracolumbar burst fracture. Despite the success of the conservative treatment in most of the cases, some patients failed the conservative treatment. The present study aimed to evaluate risk factors for the need for surgery during the follow-up period in these patients. Methods We retrospectively evaluated 67 patients with a traumatic thoracolumbar burst fracture who managed conservatively at our center between May 2014 and May 2019. Suggested variables as potential risk factors for the failure of conservative treatment including age, gender, body mass index (BMI), smoking, diabetes, vertebral body compression rate (VBCR), percentage of anterior height compression (PAHC), Cobb angle, interpedicular distance (IPD), canal compromise, and pain intensity as visual analog scale (VAS) were compared between patients with successful conservative treatment and those with failure of non-operative management. Results There were 41 males (61.2%) and 26 females (38.8%) with the mean follow-up time of 15.52 ± 5.30 months. Overall, 51 patients (76.1%) successfully completed conservative treatment. However, 16 cases (23.9%) failed the non-operative management. According to the binary logistic regression analysis, only age (risk ratio [RR], 2.21; 95% confidence interval [95%], 1.78–2.64; P = 0.019) and IPD (RR 1.97; 95% CI 1.61–2.33; P = 0.005) were the independent risk factors for the failure of the non-operative management. Conclusions Our results showed that older patients and those with greater interpedicular distance are at a higher risk for failure of the conservative treatment. As a result, a closer follow-up should be considered for them. |
| first_indexed | 2024-04-14T06:57:16Z |
| format | Article |
| id | doaj.art-a822929dfa30497f84e8a894efff2118 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T06:57:16Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-a822929dfa30497f84e8a894efff21182022-12-22T02:06:52ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-11-011511610.1186/s13018-020-02044-3Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fractureEhsan Alimohammadi0Seyed Reza Bagheri1Paniz Ahadi2Sahar Cheshmehkaboodi3Homa Hadidi4Shokofeh Maleki5Alireza Abdi6Department of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical SciencesDepartment of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical SciencesKermanshah University of Medical Sciences, Imam Reza HospitalKermanshah University of Medical Sciences, Imam Reza HospitalKermanshah University of Medical Sciences, Imam Reza HospitalClinical Research Development Center, Taleghani and Imam Ali Hospitals, Kermanshah University of Medical SciencesNursing and Midwifery School, Imam Reza Hospital, Kermanshah University of Medical SciencesAbstract Background There is a controversy about the management of patients with a thoracolumbar burst fracture. Despite the success of the conservative treatment in most of the cases, some patients failed the conservative treatment. The present study aimed to evaluate risk factors for the need for surgery during the follow-up period in these patients. Methods We retrospectively evaluated 67 patients with a traumatic thoracolumbar burst fracture who managed conservatively at our center between May 2014 and May 2019. Suggested variables as potential risk factors for the failure of conservative treatment including age, gender, body mass index (BMI), smoking, diabetes, vertebral body compression rate (VBCR), percentage of anterior height compression (PAHC), Cobb angle, interpedicular distance (IPD), canal compromise, and pain intensity as visual analog scale (VAS) were compared between patients with successful conservative treatment and those with failure of non-operative management. Results There were 41 males (61.2%) and 26 females (38.8%) with the mean follow-up time of 15.52 ± 5.30 months. Overall, 51 patients (76.1%) successfully completed conservative treatment. However, 16 cases (23.9%) failed the non-operative management. According to the binary logistic regression analysis, only age (risk ratio [RR], 2.21; 95% confidence interval [95%], 1.78–2.64; P = 0.019) and IPD (RR 1.97; 95% CI 1.61–2.33; P = 0.005) were the independent risk factors for the failure of the non-operative management. Conclusions Our results showed that older patients and those with greater interpedicular distance are at a higher risk for failure of the conservative treatment. As a result, a closer follow-up should be considered for them.http://link.springer.com/article/10.1186/s13018-020-02044-3Burst fractureThoracolumbarConservative treatmentRisk factors |
| spellingShingle | Ehsan Alimohammadi Seyed Reza Bagheri Paniz Ahadi Sahar Cheshmehkaboodi Homa Hadidi Shokofeh Maleki Alireza Abdi Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture Journal of Orthopaedic Surgery and Research Burst fracture Thoracolumbar Conservative treatment Risk factors |
| title | Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture |
| title_full | Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture |
| title_fullStr | Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture |
| title_full_unstemmed | Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture |
| title_short | Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture |
| title_sort | predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture |
| topic | Burst fracture Thoracolumbar Conservative treatment Risk factors |
| url | http://link.springer.com/article/10.1186/s13018-020-02044-3 |
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