Abstract
We retrospectively reviewed 31 neurologically intact patients with burst L1 fractures. We obtained a follow-up clinical evaluation after a mean of 43 (14–80) months from 26 patients—11 treated surgically and 15 managed non-surgically. Patients were assessed with regard to pain, employment status, recreational activities and overall satisfaction. At final follow-up of 15 patients managed non-surgically, six had little or no pain; 12 had returned to work with six declaring little or no restrictions, and eight had returned to the same level of recreational activity as prior to injury with seven declaring little or no restrictions. Of 11 patients treated surgically, four had little or no pain; seven had returned to work with three declaring little or no restrictions, three had returned to the same level of recreational activity as prior to injury and four declared little or no restrictions. There was no correlation found between vertebral collapse, kyphosis, retropulsion and clinical outcome. Patients who had non-operative management reported a good functional outcome. However, patients who required surgical stabilisation due to different fracture characteristics reported a poorer functional outcome.
Résumé
Nous avons examiné rétrospectivement 31 malades avec une burst fracture de L1, sans trouble neurologique. Nous avons obtenu une évaluation clinique après un suivi moyen de 43 mois (14–80) pour 26 malades, 11 traités chirurgicalement et 15 non-chirurgicalement. Les malades ont été répartis selon la douleur, le statut de l’emploi, les activités de loisirs et la satisfaction globale. Au dernier examen des 15 malades traités non-chirurgicalement, six avaient peu ou aucune douleur; 12 avaient repris leur travail avec six déclarant peu ou aucune restriction et huit étaient revenus, pour les activités de loisirs, au même niveau qu’avant la fracture avec sept déclarant peu ou aucune restriction. Parmi les 11 malades traités chirurgicalement, quatre avaient peu ou aucune douleur; sept avaient repris le travail avec trois déclarant peu ou aucune restriction, trois étaient revenus au même niveau d’activité de loisirs et quatre déclaraient peu ou aucune restriction. Aucune corrélation n’a été trouvé entre le collapsus vertébral, la cyphose, la rétropulsion et le résultat clinique. Les malades qui avaient été traité non-chirurgicalement ont rapporté un bon résultat fonctionnel. Les malades qui ont nécessité une stabilisation chirurgicale à cause des caractéristiques de la fracture ont rapporté un résultat fonctionnel moins bon.
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