@article {Angelliaume:2017:1060-152X:73,
title = "Conservative treatment of pediatric thoracic and lumbar spinal fractures: outcomes in the sagittal plane",
journal = "Journal of Pediatric Orthopaedics B",
parent_itemid = "infobike://wk/jpob",
publishercode ="wk",
year = "2017",
volume = "26",
number = "1",
publication date ="2017-01-01T00:00:00",
pages = "73-79",
itemtype = "ARTICLE",
issn = "1060-152X",
eissn = "1473-5865",
url = "https://www.ingentaconnect.com/content/wk/jpob/2017/00000026/00000001/art00013",
doi = "doi:10.1097/BPB.0000000000000329",
keyword = "spinopelvic parameters, growing spine, sagittal balance, conservative treatment, thoracic and lumbar fractures",
author = "Angelliaume, Audrey and Simon, Anne-Laure and Boissi{\‘e}re, Louis and Bouty, Aurore and Sales de Gauzy, J{\’e}r{\^o}me and Vital, Jean-Marc and Gille, Olivier and Tournier, Cl{\’e}ment and Aunoble, St{\’e}phane and Pontailler, Jean-Roger and Lef{\‘e}vre, Yan",
abstract = "To assess sagittal plane spinopelvic balance and functional outcomes in a pediatric cohort of patients with a thoracic and/or a lumbar fracture treated conservatively. A multicentric study retrospectively reviewed radiological and functional outcomes (mean follow-up 49 months) of 48
patients (mean age 12 years) with thoracic and/or lumbar spinal fractures that occurred between 1996 and 2014. Demographic data and radiological spinopelvic parameters were analyzed. Functional outcome was evaluated by a telephone interview. First, a comparison between the initial and the
last follow-up full-spine radiographs was performed for the assessment of bone remodeling and sagittal plane balance. Then, patients were classified into two groups (group 1: Risser2 and group 2, Risser>2) to assess the influence of skeletal maturity on the restoration of a correct
sagittal balance. A total of 62% of the patients were at skeletal maturity at the final follow-up (Risser 4 and 5). Patients with a Risser grade of 2 or less had a higher remodeling potential. The mean residual local kyphosis in thoracic and lumbar fractures was, respectively, 8.2\textdegree and
8.7\textdegree. The mean thoracic global kyphosis remains stable at the last follow-up, in contrast to lumbar lordosis, which increased significantly. Sagittal plane global measurements on the basis of the C7-plumbline remained unchanged at the last follow-up. There was no change in the pelvic parameters,
except for the sacral slope in the group 1 for patients with a lumbar fracture. The current study confirms a greater correction in younger patients (Risser2) in spinal fractures and reported that thoracic fractures have a higher remodeling potential than lumbar fracture. A local kyphosis
of almost 10\textdegree remained at the last follow-up. However, no deterioration in the sagittal plane balance was found. This suggests compensatory mechanisms in adjacent structures for children and adolescents and excludes the only hypothesis of bone remodeling.",
}