The role of surgical treatment in the rehabilitation protocols of thoraco-lumbar spine injuries

F. De Iure, J. Bonavita, M. Saccavini, L. Mavilla, Giuseppe Bosco, S. Boriani

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Rehabilitation is a crucial issue in the management of spinal cord injuries (SCI) but, in these patients, the primary treatment can bias the outcome of recovery protocols. AIM: Purpose of this paper is to review our case load in the treatment of surgical failures and to define the role of surgery in thoraco-lumbar injuries rehabilitation. PATIENTS AND METHODS: Between 2000 and 2009 seventy patients with post-traumatic paraplegia were referred to Surgical Department as rehabilitation was unfeasible due to inadequate spine injury treatment. Forty-six had had surgery, 24 were treated conservatively Twenty-five patients had a thoracic lesion, 9 a lumbar lesion and 36 a lesion of the thoraco-lumbar junction. A total of 44 surgical procedures were performed (by anterior, posterior or anterior-posterior). RESULTS: On postoperative imaging sagittal alignment was found good in 93% of cases and acceptable in 7%. All patients regained the sitting position within 5 days after surgery. Wound healing problems requiring revision were observed in 4 cases. Major complications were a cerebro spinal fluid (CSF) leakage and a massive pulmonary embolism case in the early post-op. CONCLUSIONS: Wrong primary treatment frequently leads to demanding revision procedures with increased risks for the patient and more than double costs for the health care system. Whatever the technique a stable spine is the target in surgery of SCI allowing a quick and effective rehabilitation without external orthosis.

Original languageEnglish
Pages (from-to)2933-2940
Number of pages8
JournalEuropean Review for Medical and Pharmacological Sciences
Volume17
Issue number21
Publication statusPublished - 2013

Fingerprint

Spine
Rehabilitation
Wounds and Injuries
Spinal Cord Injuries
Therapeutics
Orthotic Devices
Paraplegia
Treatment Failure
Posture
Ambulatory Surgical Procedures
Pulmonary Embolism
Wound Healing
Cerebrospinal Fluid
Thorax
Delivery of Health Care
Costs and Cost Analysis

Keywords

  • Rehabilitation
  • Spinal cord injury
  • Surgical treatment

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

Cite this

De Iure, F., Bonavita, J., Saccavini, M., Mavilla, L., Bosco, G., & Boriani, S. (2013). The role of surgical treatment in the rehabilitation protocols of thoraco-lumbar spine injuries. European Review for Medical and Pharmacological Sciences, 17(21), 2933-2940.

The role of surgical treatment in the rehabilitation protocols of thoraco-lumbar spine injuries. / De Iure, F.; Bonavita, J.; Saccavini, M.; Mavilla, L.; Bosco, Giuseppe; Boriani, S.

In: European Review for Medical and Pharmacological Sciences, Vol. 17, No. 21, 2013, p. 2933-2940.

Research output: Contribution to journalArticle

De Iure, F, Bonavita, J, Saccavini, M, Mavilla, L, Bosco, G & Boriani, S 2013, 'The role of surgical treatment in the rehabilitation protocols of thoraco-lumbar spine injuries', European Review for Medical and Pharmacological Sciences, vol. 17, no. 21, pp. 2933-2940.
De Iure, F. ; Bonavita, J. ; Saccavini, M. ; Mavilla, L. ; Bosco, Giuseppe ; Boriani, S. / The role of surgical treatment in the rehabilitation protocols of thoraco-lumbar spine injuries. In: European Review for Medical and Pharmacological Sciences. 2013 ; Vol. 17, No. 21. pp. 2933-2940.
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