Abstract
Background:
Outcome after traumatic spinal fracture is difficult to predict. Some patients have ongoing pain while others make a good recovery and there is therefore considerable debate as to which fractures should be treated operatively. Delayed operations for ongoing pain post fracture are more expensive with a longer recovery.
The sagittal balance of the spine may predict patient outcomes post fracture.
Aim:
Identify subjects with stable spine fractures not requiring acute fixation and compare their sagittal parameters measured on initial standing x-ray with whether or not they have ongoing pain.
Methods:
A retrospective review was undertaken of patients presenting with a spine fracture to North Bristol Trust over a five year period.
Sagittal parameters on initial standing x-rays were measured. The presence or absence of pain at last follow up was recorded.
Results:
399 fractures were identified. 100 were taken to theatre for acute fixation. Only 120 of those remaining had x-rays available which allowed full sagittal parameters to be measured. Clinical outcomes were available on 97 of these subjects
The measurement of pelvic incidence was not found to be significantly different in the two groups (p=0.218). The differences in pelvic tilt between those with and without pain was significant (p=0.004).
Conclusion:
A lower pelvic tilt correlates with pain post fracture. Whether this is predictive of pain or not is unclear.
Further investigation is indicated to examine the clinical outcomes and economic impact on subjects presenting with a fracture of the spine as well as the economic impact to the health service.
