Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Critical radiographic findings and medical comorbidities in the management of thoracolumbar burst fractures.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Obeng-Gyasi Barnabas, Chinthala Anoop S, Brown Ethan D L, Abraham Benjaman, Pabón-Rodríguez Félix, Griffin Taliyah S, Young Kailah, Line Trenton A, Snyder Iii William, Dalal Om, Christodoulides Alexei, Elsamadicy Aladine A, Mao Gordon
Аннотация
BACKGROUND: Burst fractures represent a significant form of spinal trauma and frequently prompt surgical decision-making. The objective of this study is to quantify the association between pre-injury factors, including body mass index (BMI), kyphotic deformity, retropulsion, and posterior ligamentous complex (PLC) injury, and the likelihood of surgical intervention in patients with burst fractures.
METHODS: We conducted a retrospective cohort study using a comprehensive statewide database from a Level 1 Trauma Center, including 185 patients with burst fractures from January 2018 to December 2023. The primary outcome was surgical versus conservative management. Patients were categorized by BMI according to World Health Organization classification, and radiographic parameters including kyphotic angle, retropulsion, vertebral height loss, and PLC injury were measured. Logistic regression analysis evaluated the association between these factors and surgical intervention, adjusting for potential confounders.
RESULTS: Class III obesity showed a statistically significant association with increased odds of surgical intervention (OR 10.6, 95% CI: 1.74-94.0, p = 0.016). Other significant predictors included retropulsion ≥ 5.05 mm (OR 4.21, 95% CI: 1.59-11.5, p = 0.004) and AP canal diameter ≥ 9.74 mm (OR 0.21, 95% CI: 0.07-0.57, p = 0.002). Burst fractures involving both endplates and kyphotic angle ≥ 15.7° were not statistically significant. PLC injury and chronic kidney disease did not reach significance in the final model. The predictive model demonstrated excellent discrimination (AUC 0.87) with high accuracy (0.81), sensitivity (0.71), and specificity (0.88).
CONCLUSIONS: Class III obesity, AP canal diameter ≤ 9,74 mm and retropulsion ≥ 5.07 mm significantly increase the likelihood of surgical intervention in patients with burst fractures, independent of other established risk factors. This multifactorial model may help guide clinical decision-making for burst fracture management.
METHODS: We conducted a retrospective cohort study using a comprehensive statewide database from a Level 1 Trauma Center, including 185 patients with burst fractures from January 2018 to December 2023. The primary outcome was surgical versus conservative management. Patients were categorized by BMI according to World Health Organization classification, and radiographic parameters including kyphotic angle, retropulsion, vertebral height loss, and PLC injury were measured. Logistic regression analysis evaluated the association between these factors and surgical intervention, adjusting for potential confounders.
RESULTS: Class III obesity showed a statistically significant association with increased odds of surgical intervention (OR 10.6, 95% CI: 1.74-94.0, p = 0.016). Other significant predictors included retropulsion ≥ 5.05 mm (OR 4.21, 95% CI: 1.59-11.5, p = 0.004) and AP canal diameter ≥ 9.74 mm (OR 0.21, 95% CI: 0.07-0.57, p = 0.002). Burst fractures involving both endplates and kyphotic angle ≥ 15.7° were not statistically significant. PLC injury and chronic kidney disease did not reach significance in the final model. The predictive model demonstrated excellent discrimination (AUC 0.87) with high accuracy (0.81), sensitivity (0.71), and specificity (0.88).
CONCLUSIONS: Class III obesity, AP canal diameter ≤ 9,74 mm and retropulsion ≥ 5.07 mm significantly increase the likelihood of surgical intervention in patients with burst fractures, independent of other established risk factors. This multifactorial model may help guide clinical decision-making for burst fracture management.