eMedicine Specialties > Orthopedic Surgery > Spine

Thoracic Spine Fractures and Dislocations: Follow-up

Author: Michael Leahy, MD, Staff Physician, Department of Orthopedic Surgery, Baylor - All Saints Hospital, Harris Methodist Hospital of Fort Worth
Coauthor(s): Mark Rahm, MD, Vice Chair and Residency Program Director, Assistant Professor, Texas A&M University Health Science Center; Consulting Staff, Department of Orthopedic Surgery, Scott and White Memorial Hospital
Contributor Information and Disclosures

Updated: Dec 3, 2009

Outcome and Prognosis

The results are favorable for correction of deformity, maintenance of reduction, healing, and fusion rates. Overall clinical outcome is generally good, depending on the patient's final neurologic function. Return of neurologic function, however, is variable, with little significant recovery seen in complete injuries irrespective of treatment.

Future and Controversies

Video-assisted thorascopic surgery (VATS) allows for minimally invasive correction of spinal deformities. Currently in some centers, it is performed for thoracic spine fractures requiring anterior bone grafting and stabilization. The benefits of this minimally invasive approach have yet to be proven, and the learning curve is steep; however, the morbidity of an open thoracotomy is avoided. Research continues in many areas, including spinal cord injuries and timing of surgery, in regard to neurologic function.

Thoracic pedicle screw placement can be challenging due to the smaller dimensions of the thoracic pedicle compared to the lumbar pedicle. Cortical disruptions have been reported to occur up to 50% of the time at some institutions using standard fluoroscopic techniques. Computer image guidance is useful when dealing with difficult anatomy, such as in placing thoracic pedicle screws and in rotational deformities. However, a clear role in spine trauma management has not been found.

 


More on Thoracic Spine Fractures and Dislocations

Overview: Thoracic Spine Fractures and Dislocations
Workup: Thoracic Spine Fractures and Dislocations
Treatment: Thoracic Spine Fractures and Dislocations
Follow-up: Thoracic Spine Fractures and Dislocations
Multimedia: Thoracic Spine Fractures and Dislocations
References
Further Reading
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References

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Keywords

thoracic spine fracture, thoracic spine dislocation, spinal column injury, thoracolumbar injuries, neurologic injury, thoracic spine fractures, Denis classification, pedicle screw fixation

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Contributor Information and Disclosures

Author

Michael Leahy, MD,  Staff Physician, Department of Orthopedic Surgery, Baylor - All Saints Hospital, Harris Methodist Hospital of Fort Worth
Disclosure: Nothing to disclose.

Coauthor(s)

Mark Rahm, MD, Vice Chair and Residency Program Director, Assistant Professor, Texas A&M University Health Science Center; Consulting Staff, Department of Orthopedic Surgery, Scott and White Memorial Hospital
Mark Rahm, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, North American Spine Society, Texas Medical Association, and Texas Orthopaedic Association
Disclosure: K2M Grant/research funds Consulting; Depuy Spine Grant/research funds None; Stryker Grant/research funds None

Medical Editor

Lee H Riley III, MD, Chief, Division of Orthopedic Spine Surgery, Assistant Professor, Departments of Orthopedic Surgery and Neurosurgery, Johns Hopkins University
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

William O Shaffer, MD, Professor, Vice-Chairman and Residency Program Director, Department of Orthopedic Surgery, University of Kentucky at Lexington
William O Shaffer, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, International Society for the Study of the Lumbar Spine, Kentucky Medical Association, Kentucky Orthopaedic Society, North American Spine Society, Southern Medical Association, and Southern Orthopaedic Association
Disclosure: DePuySpine 1997-2007 (not presently) Royalty Consulting; DePuySpine 2002-2007 (closed) Grant/research funds SacroPelvic Instrumentation Biomechanical Study; DePuyBiologics 2005-2008 (closed) Grant/research funds Healos study just closed; No present Industry grants or funds. None None

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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