Instability in Thoracolumbar Trauma

Salman Abbasi Fard, Jesse Skoch, Mauricio J. Avila, Apar S. Patel, Kamran V. Sattarov, Christina M. Walter, Ali A. Baaj

Research output: Research - peer-reviewReview article

Abstract

Study Design: Review of the articles. Objective: The objective of this study was to review all articles related to spinal instability to determine a consensus statement for a contemporary, practical definition applicable to thoracolumbar injuries. Summary of Background Data: Traumatic fractures of the thoracolumbar spine are common. These injuries can result in neurological deficits, disability, deformity, pain, and represent a great economic burden to society. The determination of spinal instability is an important task for spine surgeons, as treatment strategies rely heavily on this assessment. However, a clinically applicable definition of spinal stability remains elusive. Materials and Methods: A review of the Medline database between 1930 and 2014 was performed limited to papers in English. Spinal instability, thoracolumbar, and spinal stability were used as search terms. Case reports were excluded. We reviewed listed references from pertinent search results and located relevant manuscripts from these lists as well. Results: The search produced a total of 694 published articles. Twenty-five articles were eligible after abstract screening and underwent full review. A definition for spinal instability was described in only 4 of them. Definitions were primarily based on biomechanical and classification studies. No definitive parameters were outlined to define stability. Conclusions: Thirty-six years after White and Panjabi's original definition of instability, and many classification schemes later, there remains no practical and meaningful definition for spinal instability in thoracolumbar trauma. Surgeon expertise and experience remains an important factor in stability determination. We propose that, at an initial assessment, a distinction should be made between immediate and delayed instability. This designation should better guide surgeons in decision making and patient counseling.

LanguageEnglish (US)
PagesE1046-E1049
JournalClinical Spine Surgery
Volume30
Issue number8
DOIs
StatePublished - 2017

Fingerprint

Wounds and Injuries
Surgeons
Spine
Manuscripts
Counseling
Consensus
Decision Making
Economics
Databases
Pain
Therapeutics

Keywords

  • review articles
  • spinal instability
  • spinal stability
  • thoracolumbar

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Abbasi Fard, S., Skoch, J., Avila, M. J., Patel, A. S., Sattarov, K. V., Walter, C. M., & Baaj, A. A. (2017). Instability in Thoracolumbar Trauma. Clinical Spine Surgery, 30(8), E1046-E1049. DOI: 10.1097/BSD.0000000000000314

Instability in Thoracolumbar Trauma. / Abbasi Fard, Salman; Skoch, Jesse; Avila, Mauricio J.; Patel, Apar S.; Sattarov, Kamran V.; Walter, Christina M.; Baaj, Ali A.

In: Clinical Spine Surgery, Vol. 30, No. 8, 2017, p. E1046-E1049.

Research output: Research - peer-reviewReview article

Abbasi Fard, S, Skoch, J, Avila, MJ, Patel, AS, Sattarov, KV, Walter, CM & Baaj, AA 2017, 'Instability in Thoracolumbar Trauma' Clinical Spine Surgery, vol 30, no. 8, pp. E1046-E1049. DOI: 10.1097/BSD.0000000000000314
Abbasi Fard S, Skoch J, Avila MJ, Patel AS, Sattarov KV, Walter CM et al. Instability in Thoracolumbar Trauma. Clinical Spine Surgery. 2017;30(8):E1046-E1049. Available from, DOI: 10.1097/BSD.0000000000000314
Abbasi Fard, Salman ; Skoch, Jesse ; Avila, Mauricio J. ; Patel, Apar S. ; Sattarov, Kamran V. ; Walter, Christina M. ; Baaj, Ali A./ Instability in Thoracolumbar Trauma. In: Clinical Spine Surgery. 2017 ; Vol. 30, No. 8. pp. E1046-E1049
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