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ORIGINAL ARTICLE
Year : 2017  |  Volume : 30  |  Issue : 2  |  Page : 555-563

Evaluation ofclinicaland surgical outcomes of management of pathological fractures of the dorsolumbar spine


1 Department of Neurosurgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Neurosurgery, Shibin El-Kom Teaching Hospital, Shibin El-Kom, Egypt

Correspondence Address:
Ashraf A Zaki Abd Al Karim
Department of Neurosurgery, Shibin El.Kom Teaching Hospital, Shibin El-Kom, 32511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.215448

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Objectives The aim of this study was to evaluate the clinical and surgical outcomes of management of pathological dorsal and lumbar spine fractures. Background Pathological fractures are fractures that occur in diseased bone. Bone can be weakened by cancer, infection, or the natural aging process. In the spine, this usually occurs in the cancellous vertebral body, leading to vertebral compression fractures that can cause pain, neural compromise, and deformity. Patients and methods A retrospective study was carried out on 50patients who underwent surgical treatment for pathological fractures in the dorsal and lumbar spine. The patients were divided into three groups according to the underlying disease causing the fracture: groupA(21patients) included patients with osteoporotic fractures; groupB(18patients) included patients with neoplastic fractures; and groupC(11patients) included patients with pathological fractures due to infection. Preoperative history taking, full clinical examination, and laboratory and radiological investigations were performed for all patients. Preoperative functional assessment was performed using the Karnofsky scale, the American Spinal Injury Association scale, and the visual analog scale of pain and compared with postoperative values after 3, 6, and 12months. Results Postoperative functional evaluations showed improvement in all patients with recent neurological deficit(P=0.003, 0.016, and 0.001 in groupsA, B, and C, respectively). Significant improvement of pain in neurologically intact patients who underwent vertebral augmentations was observed(P=0.000, 0.00, and 0.03 in groupsA, B, and C, respectively). Conclusion In patients with pathological dorsal and lumbar spine fracture having neurological deficits or spinal canal compromise, the main treatment is spinal decompression and stable fusion. In the absence of neurological compromise or instability, vertebral augmentation is effective for the management of painful vertebral fractures.


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