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Corresponding Author

Ahmed Abdelazim Hassan MSc, MRCSEd

Subject Area

Trauma

Article Type

Original Study

Abstract

Background: The thoracic and lumbar spine are the two most commonly fractured regions in the vertebral column. The role of various radiographic parameters in surgical decision-making is still controversial, with many studies trying to define thoracolumbar fracture stability by correlating it to the various radiographic parameters. This prospective cross-sectional study aims to extrapolate the relationship between neurological deficit and radiographic parameters in this cohort of patients.

Methods: We included patients with thoracolumbar fractures presenting to our emergency department between November 2018 and October 2019. Neurological deficit was reported according to the American Spinal Injury Association (ASIA) score. Radiographic evaluation included plain radiographs and computerized tomography (CT) scans. Radiographic parameters, including anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), canal compromise (CC), and sagittal alignment using Cobb’s angle, were measured.

Results: In total, 160 patients were included, with an average age of 35.01 ± 14.36 years. Moreover, 122 patients (76.2%) were neurologically free, and 38 (23.8%) had a neurological deficit. Neurological deficits showed a statistically significant difference between single and multiple fractures patients. Regarding the regression analysis, the Cobb angle statistically affects the ASIA score (t = -3.64; p < 0.001). Additionally, at 23.5%, the CC had 72% sensitivity and 70% specificity in predicting the neurological deficit.

Conclusion: The Cobb angle is the strongest predictor of neurological deficit. This parameter can be crucial in predicting neurological deficits in relevant clinical situations.

Keywords

Thoracolumbar spine, spinal trauma, radiographic parameters, neurological deficit, Cobb angle

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