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The treatment for multilevel noncontiguous spinal fractures

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Abstract

We report the outcome of 30 patients with multilevel noncontiguous spinal fractures treated between 2000 and 2005. Ten cases were treated conservatively (group A), eight cases were operated on at only one level (group B), and 12 cases were treated surgically at both levels (group C). All cases were followed up for 14–60 months (mean 32 months). Initial mobilisation with a wheelchair or crutches in group A was 9.2±1.1 weeks, which was significantly longer than groups B and C with 6.8±0.7 weeks and 3.1±0.4 weeks, respectively. Operative time and blood loss in group C were significantly more than group B. The neurological deficit improved in six cases in group A (60%), six in group B (75%) and eight in group C (80%). Correction of kyphotic deformity was significantly superior in groups C and B at the operated level, and increasing deformity occurred in groups A and B at the non-operated level. From the results we believe that three treatment strategies were suitable for multilevel noncontiguous spinal fractures, and individualised treatment should be used in these patients. In the patients treated surgically, the clinical and radiographic outcomes are much better.

Résumé

Nous rapportons l’évolution de 30 patients avec des fractures étagées non contiguës du rachis traités entre 2000 et 2005 : 10 cas étaient traités conservativement (groupe A), 8 cas étaient opérés à un seul étage (groupe B), et 12 cas étaient opérés à plusieurs étages. Le suivi était de 14 à 60 mois (moyenne 32 mois). La mobilisation initiale, en chaise roulante ou avec des cannes, était significativement plus tardive que dans les groupes B et C. La durée opératoire et la perte de sang étaient plus importante dans le groupe C que dans le groupe B. Le déficit neurologique était amélioré dans 6 cas du groupe A (60%), 6 du groupe B (75%) et 8 du groupe C (80%). La correction de la cyphose était meilleure dans le groupe C et au niveau traité du groupe B tandis qu’une aggravation de la déformation était notée dans le groupe A et au niveau non opéré du groupe B. De ces résultats nous concluons que les trois traitements sont possibles mais qu’ils doivent être individualisés selon les patients. Les résultats cliniques et radiologiques sont meilleurs chez les patients opérés.

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Authors and Affiliations

  1. Department of Orthopedics, Changhai Hospital, No. 174, Changhai Road, Shanghai, 200433, People’s Republic of China

    Xiao Feng Lian, Jie Zhao, Tie Sheng Hou, Jian Dong Yuan, Gen Yang Jin & Zhong Hai Li

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  1. Xiao Feng Lian
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  2. Jie Zhao
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  3. Tie Sheng Hou
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  4. Jian Dong Yuan
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  5. Gen Yang Jin
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  6. Zhong Hai Li
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Correspondence to Jie Zhao.

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Lian, X.F., Zhao, J., Hou, T.S. et al. The treatment for multilevel noncontiguous spinal fractures. International Orthopaedics (SICO 31, 647–652 (2007). https://doi.org/10.1007/s00264-006-0241-5

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  • DOI: https://doi.org/10.1007/s00264-006-0241-5

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