![]() Decisions were made based on the radiologic imaging, that is, a 3-column fracture was an indication for operative treatment. ![]() The indication for surgical treatment was made after consultation of an expert center. Exclusion criteria were cervical spine fractures, fractures that needed operative treatment, and patients who were transferred to another hospital. The GFC is part of the Surgical Department of the hospital ZGT, Almelo, the Netherlands.Īll patients were recruited between January 1, 2009, and December 31, 2010. ![]() This study is a retrospective cohort study, which included all patients with an age of 65 years and older, who were diagnosed with a vertebral fracture and were therefore admitted to the Geriatric Fracture Center (GFC). The aims of this study are to evaluate the conservative treatment of elderly patients with a thoracolumbar spine fracture and to identify factors that influence the level of mobility after treatment. Furthermore, we want to explore which factors contribute to a level of mobility after hospital treatment for vertebral fractures among the elderly patients. We want to investigate the consequences of these changes regarding the level of mobility and the occurrence of neurological and other complications. These problems often force us to a change in treatment from immobilization to early mobilization, apparently without negative side effects. In our practice, we observed that immobilization is accompanied with problems such as pneumonia, which is a potentially lethal complication. 14, 15 Therefore, the detection of middle column damage on CT images is crucial in the diagnostic process and determines the type of treatment. It has been established that the computed tomography (CT) scan is the appropriate device to detect damage to the middle column. 7 – 9ĭamage to the middle column is crucial to determine the treatment strategy, immobilization in case of damage to the middle column, and mobilization when only the anterior column is involved. 7 – 13 Several studies also suggest that a nonoperative treatment, immobilization, followed by delayed ambulation with the use of a brace when necessary, is a safe and successful treatment for fractures involving the middle column. 6 Previous research showed that a nonoperative treatment gives the same result with regard to the level of mobility compared to an operative treatment. At this moment, no clear guidelines exist for fractures which also involve the middle column. Isolated fractures of the anterior column are usually treated by early ambulation. 2 Previous research showed that vertebral fractures are associated with an increased level of morbidity and mortality. The majority of these fractures are situated in the thoracolumbar spine, from the 10th thoracic vertebra to the 4th lumbar vertebra. The incidences of the fractures are 2 of 1000 in males and 7 of 1000 in females. The number of fractures detected in people older than 55 years of age on radiological examinations is 15.970 annually. Vertebral fractures are, together with proximal femoral and wrist fractures, the most common osteoporotic fractures among elderly patients.
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