stability of fractured T12 vertebrae

[nycgirl]

Recently found a nonacute collapsed T12 fracture from MVA 6 months ago, ongoing mild pain on right side after walking or sitting 1 hr, no neurological symptons, mild retropulsion/cord displacement, no cord edema, Xrays says 43 deg kyphosis between T11 and L1 in neutral position, 31 deg with hyperextension, flexion and extension range from 46 to 33 deg. CT scan says burst fracture. MRI and Xrays says comperssion fracture. Orthopedic consults:

#1: Unstable for additional trauma - 3 level posterior fusion with pedicle screws (stabilize without correction for kyphosis)
#2: Stable, but will continue to collapse - 3 level anterior fusion and maybe posterior also (correct for kyphosis)
#3: Stable, build ab and back muscles, re-evaluate in 6 months - 3 level anterior and posterior fusion if needed.

Please advise on next steps for determining treatment. Thank you.

[artland]

A related discussion, Bladder and Bowel Control after Burst T-12 was started.

[CCF-Neuro-M.D.-CS]

Without reviewing the films and examining you, I can not recommend a particular treatment. What I can recommend if that you have a consult at a large academic center with a spine specialist. Wish I can provide more information, but without having all of the clinical information, I can not provide a professional opinion. Good luck.

[nycgirl]

Please also advise regarding any research done comparing non-operative vs. operative treatment of this condition 6 months post accident, especially potential risks of nerve damage, etc. Thanks.

[nycgirl]

Please also advise regarding any research done comparing non-operative vs. operative treatment of this condition 6 months post accident, especially potential risks of nerve damage, etc. Thanks.