Table 2 Description of operative management cases
From: Utility of upright radiographs in traumatic thoracolumbar fracture management
Converted to Surgery After Outpaitent Follow Up | |
|---|---|
CASE 1 | CASE 2 |
Age: 76 years old | Age: 50 years old |
Sex: Female | Sex: Male |
Fracture Type: L1 Compression | Fracture Type: L1 Burst |
Polytrauma: No | Polytrauma: No |
TLICS: 1 (+ 1 for compression fracture) | TLICS: 4 (+ 2 burst, + 2 PLC indeterminate) |
Consulting Surgeon: Neurosurgeon | Consulting Surgeon: Neurosurgeon |
Factors contributing to operative decision: Endpoint X-ray at one month follow up showed an increase in kyphosis of 24.4 degrees and an increase in anterior body height loss of 45% when compared to first upright X-ray. Patient was having unbearable pain. | Factors contributing to operative decision: Endpoint X-ray at three month follow up showed slight increase in kyphosis of 3.8 degrees and an increase in anterior body height loss of 7% when compared to first upright X-ray. Increased narrowing of T12-L1 disc space and osseous retropulsion on endpoint X-ray. |
Converted to Surgery During Index Admission | |
CASE 3 | CASE 4 |
Age: 79 years old | Age: 25 years old |
Sex: Female | Sex: Male |
Fracture Type: L1 Compression | Fracture Type: T11 Burst |
Polytrauma: No | Polytrauma: Yes |
TLICS: 1 (+ 1 for compression fracture) | TLICS: 4 (+ 2 burst, + 2 PLC indeterminate) |
Consulting Surgeon: Neurosurgeon | Consulting Surgeon: Orthopaedic |
Factors contributing to operative decision: First upright X-ray showed an anterior body height loss of 77%, which was a 46% increase in kyphosis when compared to CT scan. Patient was having difficulties ambulating. | Factors contributing to operative decision: Increase in degrees of kyphosis and anterior body height loss in first upright radiograph when compared to CT scan. |
CASE 5 | CASE 6 |
Age: 62 years old | Age: 70 years old |
Sex: Female | Sex: Male |
Fracture Type: L1 Burst | Fracture Type: L1 Burst |
Polytrauma: No | Polytrauma: Yes |
TLICS: 4 (+ 2 burst, + 2 PLC indeterminate) | TLICS: 2 (+ 2 for burst fracture) |
Consulting Surgeon: Orthopaedic | Consulting Surgeon: Neurosurgeon |
Factors contributing to operative decision: Increase in degrees of kyphosis, anterior body height loss, and retropulsion (CT − 1 mm, First X-ray − 5 mm) in first upright radiograph when compared to CT scan. | Factors contributing to operative decision: Increase in degrees of kyphosis and anterior body height loss in first upright radiograph when compared to CT scan. Discussion with patient. |