Clinical application and cases examples of a new treatment algorithm for treating thoracic and lumbar spine trauma.
Spinal Cord Ser Cases 2018;
4:56. [PMID:
29977607 DOI:
10.1038/s41394-018-0093-4]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/01/2018] [Accepted: 06/02/2018] [Indexed: 11/08/2022] Open
Abstract
Study design
Review of illustrative cases of a new algorithm to help in the treatment decision of thoracolumbar spine trauma.
Objectives
To illustrate the use of the new algorithm for managing thoracic and lumbar spine trauma.
Settings
Recently, a new algorithm for helping in the decision of the best treatment modality for thoracolumbar spine trauma (TLST) was published. The algorithm considers injury morphology, neurological status, clinical status (pain and disability), and also multimodal radiological evaluation (MMRE) in the decision for non-operative versus operative treatment for TLST. Injuries were classified in three groups: (1) stable injuries, (2) potentially unstable injuries/ delayed instability, or (3) clearly unstable injuries.
Methods
Cases examples of the algorithm application were presented and discussed.
Results
Stable injuries (minor fractures without instability) are non-surgically treated; potentially unstable injuries or associated with delayed instability may be initially managed non-surgically and operative treatment is an option, especially in the setting of important pain, deformity or a new neurological deficit. Clearly unstable injuries are treated surgically as soon as possible to avoid neurological worsening, severe pain, and/ or progressive spinal deformity.
Conclusions
Clinical examples of TLST were presented, discussed and classified as stable, potentially unstable and clearly unstable injuries. Further studies addressing the reliability and safety of this algorithm are necessary.
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