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Review Question - QID 6123

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QID 6123 (Type "6123" in App Search)
A 12-year-old girl has back pain after falling 20 feet and landing in the sitting position. She has no fractures or other injuries, and her neurologic examination is normal. A lateral radiograph, transverse CT scan, and reformatted sagittal CT scan are shown in Figures 25a through 25c. Which of the following methods is associated with the best long-term outcome?
  • A
  • B
  • C

Hyperextension casting of the thoracolumbar spine for 6 weeks

14%

23/166

In situ posterior fusion with instrumentation

6%

10/166

Posterior fusion with instrumentation, with sagittal plane correction

19%

31/166

Posterior decompression, followed by posterior fusion with instrumentation, with sagittal plane correction

44%

73/166

Anterior decompression and partial corpectomy, with anterior instrumentation

16%

27/166

  • A
  • B
  • C

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The patient has a displaced burst fracture. Fusion with instrumentation has shown better results than casting alone. Posterior fusion with instrumentation, with sagittal plane correction, yields the best results. Decompression occurs indirectly with correction of the kyphosis. Anterior decompression is unnecessary.

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