Clinical long-term consequences of thoraco-lumbar spine fracture and osteosynthesis - 29/10/21
, Nicolas Luby b, c, Imène Djidjeli a, b, Ing Cheng a, b, Amaury De Barros a, b, David Brauge a, b, Franck-Emmanuel Roux a, b, d
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Abstract |
Object |
Although traumatic spine fractures can be treated by osteosynthesis, their long-term clinical, social, and familial consequences are less known. The aim of this study was to assess these global consequences to a very long-term (at least more than 12 years after the fracture).
Methods |
Two groups, one composed of 30 patients operated for a thoracolumbar fracture by posterior fixation and one with 30 controls (who never had a spinal fracture) matched for age, sex, job and time of follow-up were studied. Patients and control subjects had to answer to 3 questionnaires: one about clinical, familial, and socio-professional changes, and 2 back pain (Dallas and Eifel) scales.
Results |
The mean patient follow-up was 14.5 years (from 12 to 18 years, sd 2.3) – control subjects, 15 years. The majority (56%) of the fractures occurred at T12/L1 level. At last follow-up, the chronic low back pain concerned 20 (66,7%) patients versus 11 (36.7%) control subjects (p=0.03); more patients (13 patients – 43.3%) consumed analgesics than control (5 persons – 16.6%) subjects (p=0.04). A large majority (13 patients, 57%) had sick leaves that exceeded 6 months. The loss of wage due to traumatism or chronic low back pain was also significant (p=0.002) between patients and matched controls over the period. At follow-up, the mean Eifel score for the whole patients’ cohort was significaty superior compared to control group (4.7 [sd 3.75] vs. 2.6 [sd 4.2], p=0.008). Dallas score was superior in the patient's group for the daily, work-leisure activities and sociability aspect (p<0.05).
Conclusion |
Chronic back pain, long sick leaves, changes in professional and familial life, the very long-term postoperative outcome of patients could be more difficult than expected in a majority of patients operated for thoracolumbar fracture. In order to facilitate the back to work and reduce these long-term consequences, we propose that guidelines about job resume in traumatic spinal fractures should be established along with early occupational medicine consultations.
Level of evidence |
III; retrospective case control study.
Le texte complet de cet article est disponible en PDF.Keywords : Spinal osteosynthesis, Chronic low back pain, Sick leave, Social rehabilitation, Occupational medicine
Plan
Vol 107 - N° 7
Article 102941- novembre 2021 Retour au numéro
Article précédent
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