Long-term consequences of stable fractures of the thoracic and lumbar vertebral bodies.

Most fractures of the thoracic and lumbar vertebral bodies are stable according to the classification of Holdsworth (1963). These lesions differ from unstable fractures in that they are not usually complicated by neurological damage and mobilisation is unlikely to injure the spinal cord or nerve roots. Nevertheless, it is apparent from everyday clinical practice that not all patients make a complete and early recovery from stable fractures. There is also a variety of opinion concerning what treatment, if any, is appropriate. A review has been carried out to study the late results of stable fractures of the thoracic and lumbar vertebral bodies. The intention was to establish the incidence of persistent symptoms and also to assess residual disability. The study was retrospective. Patients had sustained fractures during the period 1963 to 1967 inclusive. They were seen in 1971 : so the follow-up period varied from eight years to a minimum of three years after injury. The patients had all been claimants on the Workmen’s Compensation Board of Ontario. In every case the patient’s claim had been finally settled and it was made clear to him that the survey would in no way affect any award he might be receiving. A search of the records produced notes of 623 patients suitable for this study. The fractures were mostly wedge compression fractures of the vertebral bodies. Many also showed infraction of one end-plate (usually the superior one) and the survey also included some bursting fractures of the vertebral bodies. Most patients were men but one in twelve was a woman. The patients came from many walks oflife but most were manual workers. Fractures occurred throughout the year and no seasonal pattern was found. Fractures were found to occur \%!ith approximately equal frequency at all ages and there was no predilection for any particular age group. Patients were widely scattered throughout the Province of Ontario and no attempt was made to trace and examine all of them. The results of this study will therefore be presented in two parts, the first consisting of material from the notes of 623 patients and the second being a clinical review of a selected proportion of these patients.