Outcomes of Pediatric Thoracic and Lumbar Spine Fracture: A Retrospective Analysis of 79 Patients

This study was aimed to investigate the radiological (deformity) and clinical outcomes following two types of medical or surgical treatment in children with spinal trauma.

This study was conducted as a retrospective cohort study containing patients of a 13 years period (2007-2019). Patients under 18 years of age who underwent medical or surgical treatment in one trauma center due to spine trauma in the thoracic and/or lumbar parts were evaluated and followed up. Demographic characteristics, mechanism of injury, clinical, radiological conditions and type of treatment were extracted from medical records. At the time of follow-up, after evaluating the neurological status and spine imaging, the primary and secondary characteristics of the patients were compared.

A total of 79 patients with an average age of 14.36 ± 3.5 years were included in this study and were followed up for an average of 36 months. The fracture was single level in 42 patients and the most common form was compression. Primary neurological deficit was present in 14% of patients, of which 2.6% had incomplete deficit and the rest had paraplegic manifestations. Thirty eight patients were treated surgically. More than one third of patients with neurological deficit at initial examination, finally had neurological improvement and were able to perform personal activities without dependence. Finally 2.53% of patients had scoliosis at the time of follow-up. Scoliosis was more common in patients who underwent surgery. Multiple level fractures was associated with lower amounts of thoracic kyphosis.

It seems that it would better to use Thoracolumbar Injury Classification and Severity Scale (TLICS) with a more surgical threshold for decision making.