Surgical Treatment for Multiple Unstable Uncomplicated Spinal Fractures in Children

Abstract

Objective. To appreciate peculiarities and efficacy of surgical treatment of children with multiple unstable uncomplicated fractures of thoracic and lumbar vertebrae. Material and Methods. Thirty-nine patients aged of 10 to 17 years with unstable uncomplicated spinal injuries were operated on, including 12 patients with fractures in thoracic spine, and 27 — in lumbar. Two fractured vertebrae were adjacent in 31 cases, and in 8 cases, one or more motion segments divided them. Twenty-two patients were admitted to the hospital in the nearest hours or days after the trauma, 6 — in 1—1.5 months, and 11 patients — after partial or complete course of conservative treatment during 2—24 months. Results. Long-term follow-up period varied from 9 months to 9 years. Vertebral body height restoration, fracture consolidation, and posterior fusion formation in patients operated on immediately or within first months after trauma were achieved in 1—1.5 years. Patients with late surgery presented anterior and posterior fusion in 1.5—2 years after surgery. Conclusion. The choice of treatment for multiple and multilevel vertebral fractures in children should be determined by the nature and term after the injury onset considering the number of injured vertebrae, their localization, and injury severity.