| Ninety percent of all spinal fractures occur in the thoracolumbar region, and burst fractures comprise approximately 10% to
20% of such injuries1-4 (fifty-nine [14%] of 412 thoracolumbar fractures in one series3 and 25,000 [15%] of 162,000
fractures in another1). Despite the fact that it is such a common fracture, there are various opinions Researchers have
advocated both an operative and a nonoperative approach. Open reduction, arthrodesis, and regarding the ideal
management, especially in patients without an associated neurological deficit. internal fixation offers the possibilities of
immediate stability, correction of deformity, early walking, reduced reliance on orthotic containment, and the theoretical
protection against spinal malalignment or neurological injury when the patient is upright. Nonoperative care, in the form of
either a body cast or a brace, offers the avoidance of a surgical intervention with its attendant morbidity. Our aim is to
compare the radiological outcome of patients with thoracolumbar and lumbar burst fractures managed operatively and nonoperatively in terms of Kyphotic deformity at fractured level, in terms of local Cobb's angle and kyphotic angle,
Restoration of vertebral height, in terms of change in anterior and posterior vertebral body heights and Sagittal parameters
of spine and pelvis, viz., lumbar lordosis, thoracic kyphosis, sagittal vertical axis, sacral slope, pelvic tilt and pelvic
incidence. In standing position vertebral column is subjected to gravitational forces creating forward bending movements
as center of gravity lies ventral to S1 vertebra. Fracture of vertebra will shift the axis of rotation posteriorly at the affected
segment increasing bending movements of spine and shortens of the lever arm of muscles and ligaments adding to potential
instability. Burst fracture results from compression failure of both anterior and middle columns under axial loads. Key
feature of this injury is fracture of posterior vertebral body cortex with retropulsion of bony fragments into spinal canal. It
is uncommon for a patient to develop neurological deficit with proper immobilization even in the setting of severe canal
stenosis. Usual protocol for thoracolumbar spinal fracture management is based on Thoracolumbar Injury Classification
System (TLICS). Preservation or restoration of neutral upright sagittal spinal alignment has become priority in both
deformity correction and other spinal surgeries. Sagittal spinal alignment has become an important predictor of a patient's
functional outcome after spinal surgery. Proper total spinal sagittal alignment is important to not only maintain balanced
standing posture, but also reduce the pain component of quality of life. In this study, we have compared the sagittal spinal
parameters in follow up cases of thoracolumbar and lumbar burst fractures managed non-operatively and operatively to
draw conclusions regarding mode of treatmentddd |
