Compressive fractures of thoracic spine vertebras in children: diagnosis and treatment algorithm

Summary

Aim:
The aim of our study was to assess and optimise the algorithm of diagnosis and treatment of compressive fracture of thoracis spine in children which has been used in our department and to recommend this algorithm for professional public.

Methods:
We included 189 patients treated in our childrens’ surgery clinic with diagnosis of compressive fracture of thoracic spine over 3 years (2010–2012). The diagnosis was set on the basis of anamnesis, X-ray and clinical examination. We assessed clinical symptoms, indication of hospitalization, indication of MR, day of initiation of rehabilitaon (including verticalization) and duration of hospitalization.

Results:
MR imaging was done in 124/189 (65,6 %) of patients and in 98/124 (79 %) of cases was the fracture confirmed. One hundred-fifty-four patients (89 %) was treated during hospitalization. Rehabilitation was intiated after pan relief - 5,7 day and next day was inciated verticalization. In 125/189 (66,1 %) of patients were diagnosted multiple fractures of thoracis vertebras. Mean duration of hospitalization was 7 ± 3,6 day.

Conclusion:
Compressive fractures of thoracic spine are diagnosed on the basis of anamnestic data, X-ray and clinical examination including neurological status. The diagnosis of skeletal trauma should be completed by MR to differentiate recent compressive fractures from older injury. Patients with a new fracture need to be admitted with resting regimen. Rehabilitation and verticalization is started after pain relief.

Key words:
Compressive fracture, thoracic spine, magnetic resonance, etiology, treatment algorithm.