INTRODUCTION: there has been considerable controversy regarding what constitutes the best treatment for lumbar burst fractures without neurological compromise. The percentage of spinal canal compromise has been used as a parameter of surgical indication, but its significance in patients without neurological deficit remains uncertain. OBJECTIVE: the purpose of this study was to evaluate patients with thoracolumbar burst fractures correlating the initial percentage of spinal canal compromise and the clinical results of the conservative treatment. METHODS: we have retrospectively evaluated the clinical records, radiographs and CT scans of adult patients with thoracolumbar burst fractures including the levels of T11 to L2, A3 type of Magerl's classification with less than 10 days of evolution, submitted to conservative treatment with TLSO (Jewett) or hyperextension plaster. A questionnaire was also applied including the Visual Analog Pain Scale (VAS), Denis Work and Pain Scale, Oswestry Index and the Quality of Life assessment questionnaire SF-36. RESULTS: it was not found correlation between the percentage of spinal compromise and the VAS or the Denis pain scale. Negative correlation was found between the percentage of spinal canal compromise and the Denis work scale. Negative correlation was also found between the Oswestry index and the percentage of spinal canal compromise, indicating that patients with higher disability scores presented less percentage of spinal canal stenosis. In the correlation analysis between the SF-36 values and the percentage of spinal canal stenosis, significant correlation was found only with the Physical Functioning domain, suggesting that the patients with best physical function also presented higher percentage of stenosis. CONCLUSION: the obtained results confirm the absence of correlation between higher percentages of spinal canal compromise and worse clinical results as described in literature.
Spinal fractures; Spinal stenosis; Spinal canal; Thoracic vertebrae; Lumbar vertebrae
