Incidence of vertebral pedicle fracture occurrence in thoracic and lumbar spine trauma. A CT-scan anatomical assessment.

STUDY

DESIGN

Retrospective cohort study.

OBJECTIVE

To determine the incidence and risk factors of VP fractures in thoracic and lumbar spine injuries.

METHODS

287 patients were included, and clinical data were collected. From the CT-scans, the presence of VP fracture, Magerl classification, fracture comminution, anatomy of the VP, level of spinal injury, type of VP fracture were assessed. The incidence of VP fractures and their associated risk factors were determined via a Spearman correlation study.

RESULTS

Seventy-three patients (25.4%) with a mean age of 50-years-old (95% CI [30.0-70.1]) presented a VP fracture and most (51 patients (69.9%)) had no neurological deficit. VP fractures were unilateral in 57 patients (78.1%) and bilateral in 16 patients (21.9%). Axial VP fractures were linked to Magerl B2 fractures (p < 0.05) while coronal VP fractures were associated with an extensive vertebral fracture comminution (p < 0.05). The incidence of VP fractures increased with severe neurological spinal injury (ASIA B; p < 0.05), Magerl B2 fractures (p < 0.001), Magerl C1-C2 fractures (p < 0.05) and an important fracture comminution (p < 0.05). Communited Magerl A3 fractures were associated with unipedicular fracture, whereas Magerl B2 fractures were linked to bipedicular fractures (p < 0.05). With regard to the type of VP fracture, axial pedicle fractures are found more often in cases of bilateral pedicular fractures (p < 0001). Morphometric data, anatomical characteristics of the VP and the type of trauma did not influence the VP fracture occurrence.

CONCLUSION

Incidence of VP fractures is non-negligible and should be more considered in future classifications of thoracic and lumbar spines injuries.