Recovery of Neurological Injury in Patients with Thoracolumbar Spine Fracture Relevant to the Fracture Pattern

Abstract
Background: Thoracolumbar fracture is the most common skeletal injury of the axial skeleton and accounts for around 90% of all spinal fractures. Spinal cord injury occurs in about 10-30%of traumatic spinal fractures. Many studies included age of the patients and initial canal compromise as variables associated with neurological recovery after neurologic injury with spinal fracture but little documentation in the literature is found on the relationship between fracture patterns assessed by AO classification and neurologic recovery.
Aim of Study: To analyze the relationship between fracture patterns according to AO classification and neurological recovery in patients with thoracolumbar spine fracture who underwent transpedicular screw fixation with or without canal decompression.
Patients and Methods: The 60 patients (38 men and 22 women) in this series had a follow-up of 12 months, and they were all managed surgically. AO classification had been used prospectively to determine the fracture pattern. Frankel scale was obtained before surgery, after surgery and at the final follow-up.
Results: AO-type B fractures were the commonest. The degree of neurologic deficits seen at admission was the greatest in AO-type C and the least in AO-type A while at final follow-up it was greatest in AO-type C and least in AO-type B. The neurologic recovery was the best in AO-type B, assessed by Frankel grading. The neurologic recovery was greater in the lumbar spinal fractures than the thoracic spinal fractures.
Conclusions: In conclusion, there is a significant relation between the AO classification fracture pattern and neurological insult and the percentage of neurological recovery. The fracture level is correlated with the percentage of neurological recovery. There is no relation between the degree of canal compromise and the pre-operative neurological deficit in patient. The percentage of neurological recovery is relatively better in patients undergo canal decompression compared with those don't.