Citation

Lee G, Wang Q, Zhong D, Li S, Kang J. J. Spinal Disord. Tech. 2012; ePub(ePub): ePub.

Affiliation

Department of Spine Surgery, The Affiliated Hospital, Luzhou Medical College, Sichuan Province, China.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/BSD.0b013e3182779b9f

PMID

23075856

Abstract

STUDY DESIGN:: A prospective,consecutive case series. OBJECTIVE:: To evaluate which variable has a strong association with neurologic damage in thoracolumbar burst fractures(T12 or L1): injury severity or narrowing of the spinal canal. SETTING:: Department of Spine Surgery, the Affiliated Hospital, Luzhou Medical College, Sichuan Province,China. METHODS:: This study covered 42 patients with thoracolumbar junction burst fractures(T12 or L1), 24 neurologic deficit patients and 18 without. Injury severity was determined by the use of the Injury Severity Score(ISS) and New Injury Severity Score(NISS), and the axial CT measure the narrowing of the spinal canal. The statistical comparison between the neurologic deficit and the non-neurologic deficit was demonstrated by nonparametric tests (Mann-Whitney Test). And the correlation of theses scores and narrowing of the spinal canal to the neurologic status was indicated by a spearman correlation test. RESULT:: The higher ISS (21 vs. 11), NISS (30 vs. 15), ISSM (13 vs. 11), NISSM (21 vs. 15), and canal compromise (48 vs. 25) were occurred in the neurologic deficit patients, which could evidently manifest the statistical difference between patients with neurologic deficit and without (P<0.01) and they also had a positive correlation with the ASIA score (r>0.5, P<0.001). What's more, there are also a positive correlation (r=0.375, P<0.05)between ISSM and ASIA scores, although it appeared weak. Other finding was that the correlations between the NISS, NISSM and neurologic deficit (respectively r=0.868, P<0.001; r=0.676, P<0.001) was stronger than with the narrowing of the spinal canal (r=0.560, P<0.001). CONCLUSIONS:: NISS have a closer correlation with neurological deficit in thoracolumbar burst fractures, so we can put forward a hypothesis that perhaps NISS is able to be on the behalf of the dynamic fracture process.

Language: en