Neurological symptomatology features in patients with spine and spinal cord trauma at the thoracolumbar junction level

Abstract

Background. Traumatic injuries to the thoracolumbar junction account for over 60 % of all injuries to the thoracolumbar spine. The neurological symptomatology accompanying injuries at this level is characterized by diverse patterns of both motor and sensory dysfunction, which are determined by the topographic-anatomical features of this area. Neurological deficit may be caused by conductive, segmental, and radicular disturbances. The aim of the study is to determine the nature and frequency of neurological disorders in patients with spine and spinal cord trauma at the level of the thoracolumbar junction, depending on the likely substrate of the traumatic impact. Materials and methods. An analysis of the neurological status assessment was conducted in 101 patients who suffered spine and spinal cord trauma at the level of the thoracolumbar junction. The average age of the patients was 41 years (95% confidence interval 36–44). Most patients were male (75.25 %). The number of motor segments with signs of upper and lower motor neuron lesion, and dermatomes with sensory impairment of radicular, segmental, or conductive types were determined. Results. It was found that 83.5 % of motor segments with dysfunction had clinical signs of lower motor neuron lesion, 41.3 % of dermatomes with sensory impairment had traumatic root damage, 57.9 % of dermatomes showed impairments of a segmental type, and 28.9 % were of a conductive type. Conclusions. The data obtained indicate a significant role of segmental disturbances in forming the symptoms in patients with spine and spinal cord trauma at the level of the thoracolumbar junction.