Patología traumática de la encrucijada toracolumbar

A retrospective study on traumatic injuries of the thoraco lumbar area has beeo done, in order to performe an algoritmic delcisión system attempting to standarize therapeutic criteria in future cases. During the period 1972-79, 59 patients in these conditions were admitted, being distributed in 5 groups: I-local contusions and fractures of the processes of the posterior arch (13 cases); II-stable vertebral fractures without neurological manifestations (25 cases); or, III-with neurological symptoms (7 cases); IV-unstable vertebral fractureswithout neurological deficits (8 cases); or, V-with neurological manifestations (6 cases). In cases with local contusions or stable fractures a conservative orthopedici trestment was always stablished, that always offered good results. In cases presenting fractures-luxations, when the fracture reduction was not obtained by means of unbending methods, peroperative reduction and osteosintesis fixation was done. In cases with stationary or progressive neurologlcal affecíion a myelographic study was always performed. When a contrast stop was detecteld a descompresive laminectomy, followed by osteosintesis fixation in unstable cases, was done. In cases with negative myelography the prior conservative treatment associated to high do,se corticotherapy was maintained. Paraplegic cases were posteriorly referred to a special center also. The experience  in treating paraplegia side effects (pain and spasticity) are commented.

A retrospective study on traumatic injuries of the thoraco lumbar area has beeo done, in order to performe an algoritmic delcisión system attempting to standarize therapeutic criteria in future cases. During the period 1972-79, 59 patients in these conditions were admitted, being distributed in 5 groups: I-local contusions and fractures of the processes of the posterior arch (13 cases); II-stable vertebral fractures without neurological manifestations (25 cases); or, III-with neurological symptoms (7 cases); IV-unstable vertebral fractureswithout neurological deficits (8 cases); or, V-with neurological manifestations (6 cases). In cases with local contusions or stable fractures a conservative orthopedici trestment was always stablished, that always offered good results. In cases presenting fractures-luxations, when the fracture reduction was not obtained by means of unbending methods, peroperative reduction and osteosintesis fixation was done. In cases with stationary or progressive neurologlcal affecíion a myelographic study was always performed. When a contrast stop was detecteld a descompresive laminectomy, followed by osteosintesis fixation in unstable cases, was done. In cases with negative myelography the prior conservative treatment associated to high do,se corticotherapy was maintained. Paraplegic cases were posteriorly referred to a special center also. The experience  in treating paraplegia side effects (pain and spasticity) are commented.