PhD ceremony: R.B. Post, 13.15 uur, Academiegebouw, Broerstraat 5, Groningen
Thesis: Functional outcome after a spinal fracture
Promotor(s): prof. H.J. ten Duis
Faculty: Medical Sciences
In this thesis, we studied the functional outcome after a traumatic thoracolumbar spinal fracture without neurological deficit. Operative as well as non-operative treatment was evaluated. Functional outcome refers to a patient’s status, which is defined by the amount of pain patients experience, as well as the return to work, being able to sport, perform recreational activities etc. Operative treatment consisted of placement of dorsal screws, non-operative treatment consisted of wearing a brace for several months.
Several aspects of the functional outcome were studied. We found that de range of motion of the spinal column did not correlate with disability. In other words, a stiff or mobile back does not result in more or less disability. Furthermore, the range of motion of the whole spinal column was found to be reduced in patients who were operated on for a spinal fracture (whereas this operation only immobilizes 2 segments).
Little is known in literature about the physical capacity of patients treated non-operatively for a spinal fracture. We carried out physical tests (dynamic lifting test and cycle ergometry test), from these tests it appeared that 1/3 of patients faced a serious impairment in their physical ability. Those impairments do not influence the quality of life though.
From our data (as well as the literature) it appears that patients usually have a fairly good functional outcome after a spinal fracture. This outcome, however, is mostly measured 2 to 3 years after the fracture. Concerning the long-term outcome less is known, therefore we measured the outcome also in the long term, in the same cohort of non-operatively treated patients. Ten years post-injury, the functional outcome appeared to be equal to the outcome 4 years post-injury, no deterioration occurred. Finally, we searched for the most optimal treatment in treating spinal fractures: operative versus non-operative. From our (retrospective) analysis it appeared that both treatments result in similar outcome.
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