OPTIONS IN THE MANAGEMENT OF THORACIC AND LUMBAR BURST FRACTURES: COMPARATIVE STUDY

Between January 2000 and February 2004, ninety patients with thoracic and lumbar burst fractures with intact or incomplete neurologic deficits were treated surgically in 65 patients and conservatively in 25 patients. Surgical decompression procedures included: laminectomy 11 patients, transpedicular 24 patients, lateral extracavitary 14 patients and transthoracic 7 patients. Numerical Yale scale scoring was used for clinical assessment. L1 vertebra was most common involved in 47.8%. The mean reduced vertebral height was 59.8%. The mean canal compromise was 57.9%. The mean kyphotic angle was 25.3° in surgical and 16.7 in conservative group. The mean follow up period was 20.8 months. With mild neurological deficits or initial kyphotic angle 20°, the results was equal in surgical and conservative group, while with moderate or sever deficits, or with kyphotic angle 20° kyphotic angle surgery was better. Of all surgical procedures, lateral extra cavitary or transthoracic approaches with transpedicular or body plating were the superior P 0.05.