The walking recovery one year after surgical management of thoracolumbar burst fracture in paraplegic patients

Abstract

The aim of this study was to highlight the walking recovery after surgical management of traumatic burst fractures at the thoracolumbar junction (T10 or T11 or T12 or L1) in paraplegic patients to decide what surgeons should tell their patients to help them develop realistic expectations and potentially improve their outcome. This is a series of adult patients presented with paraplegia from isolated thoracolumbar fracture and underwent surgical intervention from August 2009 to August 2015. Patients with preexisting disability from previous neurologic condition, patients with associated severe head injury or major medical comorbidities or life-threatening injuries were excluded. Neurological status was assessed on admission using the American Spinal Injury Association (ASIA) impairment scale (AIS). The walking ability was assessed 12 months after surgery using the modified Benzel scale. This study included 53 patients with a mean age of 39.4 years (ranging from 18 years to 58 years). Patients presented with AIS grade A are 6, 18 patients with AIS grade B, and 29 patients with AIS grade C. All the patients with L1 fracture and 70.96% of the patients with T12 fracture regained the ability to walk, but unfortunately all the patients with T10 and T11 fractures didn’t regain the walking ability 12 months after surgery. The severity of spinal cord injury and hence the walking recovery were related to the spinal level of fracture. A prospectively controlled study with more patients is needed to reevaluate the walking recovery in paraplegic patients with T10 and T11 fractures.