Dorso Lumbar Fractures Type A1 Treated by Segmental Fixation versus Conservative Treatment

Abstract Background Thoracolumbar fractures types A1 of AO classification are very common spine injuries. However, its management is usually without operative intervention especially if its patients are neurologically intact. Objective Dorsolumbar fractures are treated either with operative (posterior fixation) or conservative. The aim of this study is to compare the results of conservative versus operative treatment in a certain type of fracture (type A1 dorsolumbar fracture) regarding fracture and radiological parameters. Patients and Methods 60 patients were enrolled in the current study, 29 were males and 31 were females with a mean age of 31.300 years old in non operative patients and 33.867 years old in operative patients at time of surgery. Results Regarding radiological parameters, this study included measurements of local kyphosis angle, and vertebral body wedging. The results showed statistically significant differences between preoperative values in comparison to both postoperative and follow up values. Regarding the functional assessment scores, the mean VAS was 1.125 in non operative patients and the mean VAS was 1.040 in operative patients. The mean ODI was 10.633 % in non operative patients and about 8.700% in operative patients at the last follow up visit. There is no great difference between operative and non operative patients in VAS and ODI but there is more satisfaction in operative patients. The degree of kyphosis is more in non operative patients which made few of them in mild pain in the last follow up. The complications encountered were very few, not including any major or neurological complications. Conclusion The only purpose to do fixation on those patients of type A1 fracture is to permit early ambulation and to protect them from kyphosis. but VAS and ODI have no big difference between the two groups but more in non operative in cases suffering from post traumatic kyphosis.