Meta-analysis of the frequency of thoracolumbar junction fractures in the context of traumatic spinal injuries in the adult population

Abstract

Background. Traumatic spinal injuries are a significant medical and social issue, due to both the high costs associated with initial medical care for the injured and the extensive and expensive rehabilitation required. The thoracolumbar junction (TLJ) is prone to injuries due to its biomechanical characteristics. However, the actual frequency of injuries in this area, as reported in the literature, is inconsistent. The purpose of the study was to assess the proportion of fractures at the TLJ within the overall structure of traumatic spinal injuries in the adult population. Materials and me­thods. A meta-analysis was conducted based on searches in the MEDLINE database using MeSH terms and keywords in titles and abstracts to identify studies meeting the inclusion criteria. The search identified 22 full-length articles. Data extraction and analysis were conducted by two independent experts. Results. It was found that fractures at the TLJ accoun­ted for 46.51 % (95% confidence interval (CI): 36.76–56.27 %) of the overall structure of spinal injuries, specifically fractures at level Th11 — 4.26 % (95% CI: 3.35–5.17 %), Th12 — 13.98 % (95% CI: 10.41–17.56 %), at level L1 — 22.21 % (95% CI: 17.66–26.76 %), and L2 — 9.69 % (95% CI: 6.82–12.57 %). Within the thoracolumbar division, the frequency of TLJ trauma was 61.88 % (95% CI: 52.53–71.22 %). Within the TLJ, the frequency of fractures was: vertebra Th11 — 10.2 % (95% CI: 8.05–12.36 %), Th12 — 26.56 % (95% CI: 22.42–30.7 %), vertebra L1 — 42.76 % (95% CI: 39.7–45.81 %), and L2 — 20.48 % (95% CI: 16.73–24.23 %). Conclusions. The meta-analysis provi­ded objective indicators of the frequency distribution of TLJ fractures within the overall structure of traumatic spinal injuries. To our knowledge, this is the first study to provide such detailed information through meta-analysis.