Neurologic Recovery According to the Spinal Fracture Patterns by Denis Classification

Yonsei Med J, 2013 · DOI: http://dx.doi.org/10.3349/ymj.2013.54.3.715 · Published: May 1, 2013

Spinal Disorders Rehabilitation Musculoskeletal Medicine

Simple Explanation

This study investigates the relationship between spinal fracture patterns, as classified by the Denis system, and the extent of neurologic recovery in patients who underwent surgery. The study found that while the initial severity of neurologic deficits was related to the type of fracture, the amount of neurologic recovery was not. Additionally, neurologic recovery assessed by Frankel grade was greater in the lumbar spinal fractures than in the thoracic spinal fractures.

Study Duration

October 1989 and July 1999

Participants

38 patients (26 men and 12 women)

Evidence Level

Not specified

Key Findings

1
The common injuries making neurologic deterioration were burst fracture and fracture-dislocation.
2
The severity of initial and the final follow-up neurologic deficits were correlated with the fracture patterns according to Denis classification.
3
The neurologic recovery was not correlated with fracture patterns of Denis classification.

Research Summary

This study aimed to determine the correlation between spinal fracture patterns (Denis classification) and neurologic recovery in surgically managed patients with thoracolumbar fractures and neurologic deficits. The study found that the severity of initial neurologic deficits was correlated with the fracture patterns, with fracture-dislocations showing more severe deficits than burst fractures. However, the extent of neurologic recovery was not significantly correlated with the specific fracture pattern as defined by the Denis classification.

Practical Implications

Surgical strategies

Surgical strategies may need to be tailored based on the severity of the initial neurologic deficit and fracture pattern, even if the expected neurologic recovery is not directly correlated with the fracture type.

Thoracic vs lumbar fractures

Greater attention should be given to lumbar spinal fractures.

Further research

Further research is needed to identify other factors that influence neurologic recovery after spinal fractures, as the Denis classification alone may not be sufficient for predicting recovery outcomes.

Study Limitations

1
Retrospective study design
2
Limited number of patients, especially with neurological deficits
3
Did not evaluate all four fracture patterns of Denis classification for neurologic recovery because of limited number of patients with neural deficits.

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