L4 fractures, biomechanics of cure foretold

Abstract

Objectives: To analyze the clinical and radiographic outcomes in fracture of the fourth lumbar vertebra, under conservative or surgical treatment. Methods: Patients diagnosed with L4 fracture with or without neurological injury were studied and to whom conservative or surgical treatment was provided. Radiographic measurements were performed taking into account the kyphosis angle, the sagittal index, loss of vertebral body height, percentage of canal occlusion and height compression percentage. Results: Twenty-five patients were treated, five conservatively and 20 surgically. The vertebral kyphosis angle in both groups was 12°, no regional kyphosis was present, the sagittal index was 11.9 (Farcy), the loss of vertebral body height was 53.17%, the percentage of canal occlusion was 23% and the height compression percentage was 38.06%. The residual pain according to the visual analog scale was two in both groups. Conclusions: Patients with a fractured L4 have a satisfactory outcome with both treatments, the height of the vertebral body remains the same, the lordosis is preserved and therefore the sagittal balance, allowing recovering the mechanical functions of the spine as opposed to other segment fractures.