Usporedba različitih oblika konzervativnog liječenja prijeloma torakolumbalnog prijelaza kralježnice u odnosu na intenzitet i obrasce širenja boli [Comparison of different conservative treatment options of spinal thoracolumbar junction fractures regarding pain intensity and pain distribution patterns]

BACKGROUND. Although stable compression fractures of spinal thoracolumbar junction are common injuries, medical literature is not abundant with studies analyzing outcomes of different subgroups of these fractures, or comparing different modalities of conservative treatment. AIM. To analyze the impact of fracture type and of applied immobilization on the outcome of conservative treatment. PATIENTS AND METHODS. 140 patients were included in a prospective cohort study with 12 months follow-up. Pain intensity, pain patterns, types of required analgesic therapy and perception of quality of life were analyzed. Different subgroups of fractures according to AO/ASIF classification (A 1.1., A 1.2., A 1.3.), and different forms of conservative treatment (immobilization with "Jewett" thoracolumbar orthosis or with reclination plaster cast) in patients with A 1.2. fractures were compared. RESULTS. Statistically significant difference between fracture subgroups has been demonstrated in pain patterns analysis. In contrast, the intensity of pain, use of analgesics and perception of quality of life did not aggravate with higher fracture subtype. Posttraumatic deformity of the injured vertebra did differ with in regard to used immobilization. However, patients with different immobilization showed significant difference in the pain patterns. Furthermore, in patients treated with plaster cast earlier decrease in pain intensity occurs, and a larger proportion of these patients a year after injury no longer needs any analgesic therapy. On the other hand, patients treated with orthosis achieved somewhat better results on the quality of life test during immobilization. CONCLUSIONS. Different subgroups of AO/ASIF fracture classification show different clinical manifestation regarding pain patterns. However, this classification cannot be used as a prediction factor for final treatment result. Furthermore, although there are some differences in the observed parameters depending on the immobilization type, plaster cast still represents a valid therapeutic option in the treatment of vertebral compression fractures

Ozljeda vertebralne arterije u bolesnika s prijelomom C4 kralješka

Vertebral artery injuries due to cervical spine trauma, although rarely described in the literature, are relatively common. While most of them will remain asymptomatic, a small percentage of patients may suffer life threatening complications. We report a case of the right vertebral artery injury in a patient with fracture of C4 vertebra, successfully treated with endovascular approach. A 78-year-old male patient was hospitalized for cervical spine injury caused by falling off the tractor. Radiological assessment revealed fracture of C4 vertebra with proximal two-thirds of C4 body dislocated five millimeters dorsally. Significant swelling of soft prevertebral tissues distally of C2 segment was also present. During emergency surgery using standard anterior approach for cervical spine, excessive bleeding started from the injured right vertebral artery. Bleeding was stopped by tamponade with oxidized regenerated cellulose sheet and C4-C5 anterior fixation; then partial reduction of displacement was done. Fifteen days later, after angiography, endovascular repair of the right vertebral artery was performed using percutaneous stent graft. Follow up computed tomography scan angiography showed valid stent patency without contrast extravasation. In cases of cervical spine trauma, surgeon should always be prepared to manage injury of vertebral artery. Bleeding can primarily be stopped by hemostatic packing, and definitive repair can be successfully achieved by endovascular approach using percutaneous stent graft.Oštećenja vertebralnih arterija, iako se rijetko navode u literaturi, relativno su učestale u bolesnika s ozljedom vratne kralježnice. Iako će većina bolesnika ostati asimptomatska, njihov mali postotak može zadobiti životno ugrožavajuće komplikacije. U ovom članku opisujemo ozljedu desne vertebralne arterije kod bolesnika s prijelomom C4 kralješka, koja je uspješno zbrinuta endovaskularnim pristupom. Muškarac u dobi od 78 godina hospitaliziran je zbog ozljede vratne kralježnice koju je zadobio pri padu s traktora. Radiološkom dijagnostičkom obradom potvrđen je prijelom C4 kralješka s dorzalnom dislokacijom tijela istog kralješka za 5 mm. Pritom je bila vidljiva i značajna oteklina prevertebralnih mekih tkiva distalno od C2 segmenta. Tijekom hitnog operacijskog zahvata u kojem je korišten standardni prednji pristup na vratnu kralježnicu došlo je do masivnog krvarenja iz ozlijeđene desne vertebralne arterije. Krvarenje je zaustavljeno pomoću tamponade vaticom od oksidirane regenerirane celuloze, uz prednju fiksaciju segmenta C4-C5 i parcijalnu repoziciju. Petnaest dana kasnije, nakon angiografije, učinjena je endovaskularna sanacija oštećenja desne vertebralne arterije, uz perkutano umetanje stent grafta. Kontrolno oslikavanje kompjutoriziranom tomografijom pokazalo je dobru prohodnost stenta, bez ekstravazacije kontrasta. Kirurg mora uvijek biti svjestan mogućeg oštećenja vertebralne arterije kod bolesnika s ozljedom vratne kralježnice. Krvarenje se može primarno zaustaviti hemostatskom tamponadom, a konačna se sanacija oštećenja može učiniti endovaskularnim pristupom, korištenjem perkutanog stent grafta

Utjecaj sarkopenije na vrstu prijeloma proksimalnog dijela bedrene kosti

A single-centre cross-sectional study was performed to investigate the potential association between the presence of sarcopenia and fracture patterns in patients with a proximal femoral fracture. We identified all consecutive patients who were admitted due to proximal femoral fracture. The patient’s demographic data and the presence of sarcopenia were assessed. The presence of sarcopenia was investigated preoperatively according to EWGSOP2 criteria using the SARC-F questionnaire and the hand grip strength test. According to the presence of sarcopenia, two groups were formed and analysed. We identified 70 patients who matched the inclusion criteria and were analysed in this study. In the sarcopenic group, there was a significantly higher proportion of extracapsular fractures (63.6 % vs. 26.9 %; p = 0.00298, z = 2.9684) with an increased proportion of pertrochanteric fractures (52.3 % vs. 23 %; p = 0.0164, z = 2.396) compared to the non-sarcopenic group. Also, we observed a significant difference in the proportions of femoral neck fractures between two analysed groups (36.4 % vs. 73.1 %; p = 0.0029, z = -2.9684). It is important to screen for sarcopenia and apply comprehensive geriatric care to all hip fracture patients, especially those with pertrochanteric fracture patterns.Presječno istraživanje bolesnika primljenih zbog prijeloma proksimalnog femura provedeno je u trauma centru s ciljem utvrđivanja povezanosti sarkopenije i vrste prijeloma kosti. Analizirani su demografski podatci i prisutnost sarkopenije. Za postavljanje dijagnoze sarkopenije korišteni su SARC-F upitnik i test snage stiska šake, prema EWGSOP2 kriterijima. Formirane su i analizirane dvije skupine bolesnika, sarkopenični i ne-sarkopenični. Identificirano je 70 bolesnika koji su odgovarali uključnim kriterijima te su analizirani u ovoj studiji. U sarkopeničnoj skupini utvrđen je značajno veći udio ekstrakapsularnih prijeloma (63.6 % prema 26.9 %; p = 0.00298, z = 2.9684) sa značajno većim udjelom pertrohanternih prijeloma (52.3 % prema 23 %; p = 0.0164, z = 2.396) u odnosu na ne-sarkopeničnu skupinu. Također, utvrđena je značajna razlika u udjelima prijeloma vrata femura između dvije analizirane skupine (36.4 % prema 73.1 %; p = 0.0029, z = -2.9684). Stoga je od velike važnosti probir na sarkopeniju i primijena sveobuhvatne gerijatrijske skrbi za bolesnike s prijelomom proksimalnog femura, posebno s pertrohanternim prijelomom

Surgical treatment of spondylodiscitis

Spondilodiscitis se u većini slučajeva može liječiti konzervativno, ali kompliciraniji slučajevi koji uključuju prijeteći ili postojeći neurološki ispad, nestabilnost i deformitet kralježnice, jake bolove, epiduralni apsces i neuspjeh konzervativnog liječenja zahtijevaju kirurško liječenje. Ciljevi operativnog liječenja spondilodiscitisa su odstranjenje nekrotičnog tkiva i dekompresija neuralnih struktura, uzimanje tkiva za patohistološku dijagnozu i mikrobiološku potvrdu uzročnika, stabilizacija kralježnice, te rana mobilizacija pacijenta. Moderna kirurška tehnika koristi stražnji pristup, prednji pristup i kombinirani pristup u jednom ili dva stupnja, a kirurg je vođen lokalizacijom spondilodiscitisa i individualnim pristupom pacijentu. Stabilnost kralježnice se postiže transpedikularnom fiksacijom titanskim vijcima i stupićima, a prednja kolumna torakolumbalne kralježnice se nakon odstranjenja nekrotičnog tkiva rekonstruira trikortikalnim koštanim presatkom iz zdjelice ili titanskim kavezima ispunjenim spongioznom kosti. U kirurškom liječenju spondilodiscitisa vratne kralježnice stabilnost se postiže prednjim pločama sa zaključanim vijcima i/ili stražnjom stabilizacijom vratne kralježnice. Korist stabilizacije kralježnice titanskim implantatima nadilazi manjkavost implantacije stranog materijala na mjestu upale.In most cases spondylodiscitis can be treated conservatively, though complicated cases with pending or already existent neurological deficit, focal instability or deformity of the spine with acute pain have to be treated by surgical correction and instrumentation. Surgery is absolutely indicated in cases with epidural abscess formation and in cases in which conservative treatment have given no success. Goals of surgical treatment of spondylodiscitis are debridement of necrotic and infected tissues, decompression of neural structures, obtaining specimens for bacteriological and pathohystological diagnostics, and obtainment of spine stability, making possible early mobilization of the patient. Anterior, posterior or combined approaches can be utilized, being performed in single stage of staged procedure. Leading facts determining surgeon\u27s tactics being localisation of inflammatory process and individual approach to the patient. Stability of the spine is achived by transpedicular fixation by screws and longitudinal rods, and by reconstruction of anterior column by means of cancellous bone filled titanium cages or by autologous structural bone grafting. In cervical spine surgical stability is achieved by anterior locking plates, and/or by posterior screw and rod system instrumentation. Benefit given by stabilized spine outpaces the risk of implanting metal implants in potentially contaminated area

MRI Study of the ACL in Children and Adolescents

Reconstruction of the ACL (anterior cruciate ligament) requires precise anatomical placement of the tendon graft. Anatomic variations may increase/decrease risk of the ACL rupture. Twenty-eight children with clinical, MRI and arthroscopic verified ACL ruptures were compared with match case control group. MRI was done one to 12 months after trauma. The thresholds values for identifying the ACL rupture were set; ACL angle 0°, and the PCL angle <115°. RESULTS: There was no significant difference of tibial attachment for the ACL and measured parameters of the femur. The ACL angle (p<0.001), the Blumensat angle (p=0.001), and the PCL angle (p<0.001) were significantly different. Each of the patients in group with a torn ACL had at least one parameter positive. DISCUSSION: ACL angle, Blumensat angle and PCL angle might help to diagnose ruptured ACL. Pediatric patients with the ruptured ACL show no difference in notch width or the tibial roof inclination angle as compared with pediatric patients without ACL rupture

Surgical treatment of spondylodiscitis

Spondilodiscitis se u većini slučajeva može liječiti konzervativno, ali kompliciraniji slučajevi koji uključuju prijeteći ili postojeći neurološki ispad, nestabilnost i deformitet kralježnice, jake bolove, epiduralni apsces i neuspjeh konzervativnog liječenja zahtijevaju kirurško liječenje. Ciljevi operativnog liječenja spondilodiscitisa su odstranjenje nekrotičnog tkiva i dekompresija neuralnih struktura, uzimanje tkiva za patohistološku dijagnozu i mikrobiološku potvrdu uzročnika, stabilizacija kralježnice, te rana mobilizacija pacijenta. Moderna kirurška tehnika koristi stražnji pristup, prednji pristup i kombinirani pristup u jednom ili dva stupnja, a kirurg je vođen lokalizacijom spondilodiscitisa i individualnim pristupom pacijentu. Stabilnost kralježnice se postiže transpedikularnom fiksacijom titanskim vijcima i stupićima, a prednja kolumna torakolumbalne kralježnice se nakon odstranjenja nekrotičnog tkiva rekonstruira trikortikalnim koštanim presatkom iz zdjelice ili titanskim kavezima ispunjenim spongioznom kosti. U kirurškom liječenju spondilodiscitisa vratne kralježnice stabilnost se postiže prednjim pločama sa zaključanim vijcima i/ili stražnjom stabilizacijom vratne kralježnice. Korist stabilizacije kralježnice titanskim implantatima nadilazi manjkavost implantacije stranog materijala na mjestu upale.In most cases spondylodiscitis can be treated conservatively, though complicated cases with pending or already existent neurological deficit, focal instability or deformity of the spine with acute pain have to be treated by surgical correction and instrumentation. Surgery is absolutely indicated in cases with epidural abscess formation and in cases in which conservative treatment have given no success. Goals of surgical treatment of spondylodiscitis are debridement of necrotic and infected tissues, decompression of neural structures, obtaining specimens for bacteriological and pathohystological diagnostics, and obtainment of spine stability, making possible early mobilization of the patient. Anterior, posterior or combined approaches can be utilized, being performed in single stage of staged procedure. Leading facts determining surgeon\u27s tactics being localisation of inflammatory process and individual approach to the patient. Stability of the spine is achived by transpedicular fixation by screws and longitudinal rods, and by reconstruction of anterior column by means of cancellous bone filled titanium cages or by autologous structural bone grafting. In cervical spine surgical stability is achieved by anterior locking plates, and/or by posterior screw and rod system instrumentation. Benefit given by stabilized spine outpaces the risk of implanting metal implants in potentially contaminated area

Life Threatening Complications after Unsuccessful Attempt of the Guidewire Dilating Forceps Tracheostomy in Multi-Trauma Patient with Cervical Spine Injury

Percutaneous tracheostomy (PCT) is a safe method under proper patient selection, increased technical experience and bronchoscopy- or ultrasound-guided procedure. Trauma patients with cervical spine fractures and spinal cord injury are at a high risk for respiratory failure and require a definitive airway followed by prolonged mechanical ventilation. We would like to present multiple, life- threatening complications after unsuccessful attempt of the guidewire dilating forceps tracheostomy (GWDF) in one trauma patient with a cervical spine injury. With this case report we would like to lay emphasis on the importance of continuously bronchoscopy- or ultrasound-guided PTC in trauma patients, especially with cervical spine injury, as the need to respect the steep-learning curve in its performance

Comparison of different conservative treatment options of spinal thoracolumbar junction fractures regarding pain intensity and pain distribution patterns

UVOD. Stabilni kompresijski prijelomi torakolumbalnog prijelaza kralježnice česte su ozljede, no u medicinskoj literaturi ne postoji dovoljno istraživanja koja uspoređuju ishod različitih podskupina ovih prijeloma, odnosno različite načine konzervativnog liječenja. CILJ. Analizirati utjecaj tipa prijeloma te vrstu primijenjene imobilizacije na ishod konzervativnog liječenja. ISPITANICI I METODE. Prospektivna kohortna studija s periodom praćenja od 12 mjeseci obuhvatila je 140 pacijenata. Analizirani su intenzitet i obrasci širenja boli, vrsta potrebne analgetske terapije te percepcija kvalitete života. Pritom su međusobno uspoređivani pacijenti s različitim podskupinama prijeloma prema AO/ASIF klasifikaciji (A 1.1., A 1.2. i A 1.3.), te različiti oblici konzervativnog liječenja (imobilizacija torakolumbalnom ortozom tipa Jewett, odnosno sadrenim reklinacijskim steznikom) kod pacijenata s A 1.2. podskupinom prijeloma. REZULTATI. Između pojedinih podskupina prijeloma statistički značajna razlika dokazana je u obrascima širenja boli. Nasuprot tome, intenzitet boli, korištenje analgetika i percepcija kvalitete života se ne pogoršavaju s povišenjem stupnja prijeloma. Posttraumatski deformitet ozlijeđenog kralješka ne mijenja se ovisno o primijenjenom imobilizacijskom sredstvu, no kod različite imobilizacije postoji značajna razlika u obrascima širenja boli. Nadalje, kod pacijenata liječenih sadrenim steznikom ranije dolazi do umanjenja intenziteta boli, a godinu dana po ozljedi u većem broju slučajeva više ne trebaju medikamentoznu analgetsku terapiju. Nasuprot tome, bolesnici liječeni ortozom postizali su nešto bolje rezultate na testu za ispitivanje percepcije kvalitete živote za vrijeme trajanja imobilizacije. ZAKLJUČCI. Pojedine podskupine prijeloma po AO/ASIF klasifikaciji na različitit se način klinički manifestiraju u odnosu na obrasce širenja boli. Međutim, navedom klasifikacijom nije moguće predvidjeti dobar ili loš krajnji rezultat liječenja. Nadalje, iako postoje određene razlike u promatranim parametrima ovisno o primijenjenom imobilizacijskom sredstvu, sadreni reklinacijski steznik i nadalje predstavlja valjanu terapijsku opciju u liječenju kompresijskih prijeloma kralježnice.BACKGROUND. Although stable compression fractures of spinal thoracolumbar junction are common injuries, medical literature is not abundant with studies analyzing outcomes of different subgroups of these fractures, or comparing different modalities of conservative treatment. AIM. To analyze the impact of fracture type and of applied immobilization on the outcome of conservative treatment. PATIENTS AND METHODS. 140 patients were included in a prospective cohort study with 12 months follow-up. Pain intensity, pain patterns, types of required analgesic therapy and perception of quality of life were analyzed. Different subgroups of fractures according to AO/ASIF classification (A 1.1., A 1.2., A 1.3.), and different forms of conservative treatment (immobilization with "Jewett" thoracolumbar orthosis or with reclination plaster cast) in patients with A 1.2. fractures were compared. RESULTS. Statistically significant difference between fracture subgroups has been demonstrated in pain patterns analysis. In contrast, the intensity of pain, use of analgesics and perception of quality of life did not aggravate with higher fracture subtype. Posttraumatic deformity of the injured vertebra did differ with in regard to used immobilization. However, patients with different immobilization showed significant difference in the pain patterns. Furthermore, in patients treated with plaster cast earlier decrease in pain intensity occurs, and a larger proportion of these patients a year after injury no longer needs any analgesic therapy. On the other hand, patients treated with orthosis achieved somewhat better results on the quality of life test during immobilization. CONCLUSIONS. Different subgroups of AO/ASIF fracture classification show different clinical manifestation regarding pain patterns. However, this classification cannot be used as a prediction factor for final treatment result. Furthermore, although there are some differences in the observed parameters depending on the immobilization type, plaster cast still represents a valid therapeutic option in the treatment of vertebral compression fractures

Comparison of different conservative treatment options of spinal thoracolumbar junction fractures regarding pain intensity and pain distribution patterns

UVOD. Stabilni kompresijski prijelomi torakolumbalnog prijelaza kralježnice česte su ozljede, no u medicinskoj literaturi ne postoji dovoljno istraživanja koja uspoređuju ishod različitih podskupina ovih prijeloma, odnosno različite načine konzervativnog liječenja. CILJ. Analizirati utjecaj tipa prijeloma te vrstu primijenjene imobilizacije na ishod konzervativnog liječenja. ISPITANICI I METODE. Prospektivna kohortna studija s periodom praćenja od 12 mjeseci obuhvatila je 140 pacijenata. Analizirani su intenzitet i obrasci širenja boli, vrsta potrebne analgetske terapije te percepcija kvalitete života. Pritom su međusobno uspoređivani pacijenti s različitim podskupinama prijeloma prema AO/ASIF klasifikaciji (A 1.1., A 1.2. i A 1.3.), te različiti oblici konzervativnog liječenja (imobilizacija torakolumbalnom ortozom tipa Jewett, odnosno sadrenim reklinacijskim steznikom) kod pacijenata s A 1.2. podskupinom prijeloma. REZULTATI. Između pojedinih podskupina prijeloma statistički značajna razlika dokazana je u obrascima širenja boli. Nasuprot tome, intenzitet boli, korištenje analgetika i percepcija kvalitete života se ne pogoršavaju s povišenjem stupnja prijeloma. Posttraumatski deformitet ozlijeđenog kralješka ne mijenja se ovisno o primijenjenom imobilizacijskom sredstvu, no kod različite imobilizacije postoji značajna razlika u obrascima širenja boli. Nadalje, kod pacijenata liječenih sadrenim steznikom ranije dolazi do umanjenja intenziteta boli, a godinu dana po ozljedi u većem broju slučajeva više ne trebaju medikamentoznu analgetsku terapiju. Nasuprot tome, bolesnici liječeni ortozom postizali su nešto bolje rezultate na testu za ispitivanje percepcije kvalitete živote za vrijeme trajanja imobilizacije. ZAKLJUČCI. Pojedine podskupine prijeloma po AO/ASIF klasifikaciji na različitit se način klinički manifestiraju u odnosu na obrasce širenja boli. Međutim, navedom klasifikacijom nije moguće predvidjeti dobar ili loš krajnji rezultat liječenja. Nadalje, iako postoje određene razlike u promatranim parametrima ovisno o primijenjenom imobilizacijskom sredstvu, sadreni reklinacijski steznik i nadalje predstavlja valjanu terapijsku opciju u liječenju kompresijskih prijeloma kralježnice.BACKGROUND. Although stable compression fractures of spinal thoracolumbar junction are common injuries, medical literature is not abundant with studies analyzing outcomes of different subgroups of these fractures, or comparing different modalities of conservative treatment. AIM. To analyze the impact of fracture type and of applied immobilization on the outcome of conservative treatment. PATIENTS AND METHODS. 140 patients were included in a prospective cohort study with 12 months follow-up. Pain intensity, pain patterns, types of required analgesic therapy and perception of quality of life were analyzed. Different subgroups of fractures according to AO/ASIF classification (A 1.1., A 1.2., A 1.3.), and different forms of conservative treatment (immobilization with "Jewett" thoracolumbar orthosis or with reclination plaster cast) in patients with A 1.2. fractures were compared. RESULTS. Statistically significant difference between fracture subgroups has been demonstrated in pain patterns analysis. In contrast, the intensity of pain, use of analgesics and perception of quality of life did not aggravate with higher fracture subtype. Posttraumatic deformity of the injured vertebra did differ with in regard to used immobilization. However, patients with different immobilization showed significant difference in the pain patterns. Furthermore, in patients treated with plaster cast earlier decrease in pain intensity occurs, and a larger proportion of these patients a year after injury no longer needs any analgesic therapy. On the other hand, patients treated with orthosis achieved somewhat better results on the quality of life test during immobilization. CONCLUSIONS. Different subgroups of AO/ASIF fracture classification show different clinical manifestation regarding pain patterns. However, this classification cannot be used as a prediction factor for final treatment result. Furthermore, although there are some differences in the observed parameters depending on the immobilization type, plaster cast still represents a valid therapeutic option in the treatment of vertebral compression fractures

Comparison of different conservative treatment options of spinal thoracolumbar junction fractures regarding pain intensity and pain distribution patterns

UVOD. Stabilni kompresijski prijelomi torakolumbalnog prijelaza kralježnice česte su ozljede, no u medicinskoj literaturi ne postoji dovoljno istraživanja koja uspoređuju ishod različitih podskupina ovih prijeloma, odnosno različite načine konzervativnog liječenja. CILJ. Analizirati utjecaj tipa prijeloma te vrstu primijenjene imobilizacije na ishod konzervativnog liječenja. ISPITANICI I METODE. Prospektivna kohortna studija s periodom praćenja od 12 mjeseci obuhvatila je 140 pacijenata. Analizirani su intenzitet i obrasci širenja boli, vrsta potrebne analgetske terapije te percepcija kvalitete života. Pritom su međusobno uspoređivani pacijenti s različitim podskupinama prijeloma prema AO/ASIF klasifikaciji (A 1.1., A 1.2. i A 1.3.), te različiti oblici konzervativnog liječenja (imobilizacija torakolumbalnom ortozom tipa Jewett, odnosno sadrenim reklinacijskim steznikom) kod pacijenata s A 1.2. podskupinom prijeloma. REZULTATI. Između pojedinih podskupina prijeloma statistički značajna razlika dokazana je u obrascima širenja boli. Nasuprot tome, intenzitet boli, korištenje analgetika i percepcija kvalitete života se ne pogoršavaju s povišenjem stupnja prijeloma. Posttraumatski deformitet ozlijeđenog kralješka ne mijenja se ovisno o primijenjenom imobilizacijskom sredstvu, no kod različite imobilizacije postoji značajna razlika u obrascima širenja boli. Nadalje, kod pacijenata liječenih sadrenim steznikom ranije dolazi do umanjenja intenziteta boli, a godinu dana po ozljedi u većem broju slučajeva više ne trebaju medikamentoznu analgetsku terapiju. Nasuprot tome, bolesnici liječeni ortozom postizali su nešto bolje rezultate na testu za ispitivanje percepcije kvalitete živote za vrijeme trajanja imobilizacije. ZAKLJUČCI. Pojedine podskupine prijeloma po AO/ASIF klasifikaciji na različitit se način klinički manifestiraju u odnosu na obrasce širenja boli. Međutim, navedom klasifikacijom nije moguće predvidjeti dobar ili loš krajnji rezultat liječenja. Nadalje, iako postoje određene razlike u promatranim parametrima ovisno o primijenjenom imobilizacijskom sredstvu, sadreni reklinacijski steznik i nadalje predstavlja valjanu terapijsku opciju u liječenju kompresijskih prijeloma kralježnice.BACKGROUND. Although stable compression fractures of spinal thoracolumbar junction are common injuries, medical literature is not abundant with studies analyzing outcomes of different subgroups of these fractures, or comparing different modalities of conservative treatment. AIM. To analyze the impact of fracture type and of applied immobilization on the outcome of conservative treatment. PATIENTS AND METHODS. 140 patients were included in a prospective cohort study with 12 months follow-up. Pain intensity, pain patterns, types of required analgesic therapy and perception of quality of life were analyzed. Different subgroups of fractures according to AO/ASIF classification (A 1.1., A 1.2., A 1.3.), and different forms of conservative treatment (immobilization with "Jewett" thoracolumbar orthosis or with reclination plaster cast) in patients with A 1.2. fractures were compared. RESULTS. Statistically significant difference between fracture subgroups has been demonstrated in pain patterns analysis. In contrast, the intensity of pain, use of analgesics and perception of quality of life did not aggravate with higher fracture subtype. Posttraumatic deformity of the injured vertebra did differ with in regard to used immobilization. However, patients with different immobilization showed significant difference in the pain patterns. Furthermore, in patients treated with plaster cast earlier decrease in pain intensity occurs, and a larger proportion of these patients a year after injury no longer needs any analgesic therapy. On the other hand, patients treated with orthosis achieved somewhat better results on the quality of life test during immobilization. CONCLUSIONS. Different subgroups of AO/ASIF fracture classification show different clinical manifestation regarding pain patterns. However, this classification cannot be used as a prediction factor for final treatment result. Furthermore, although there are some differences in the observed parameters depending on the immobilization type, plaster cast still represents a valid therapeutic option in the treatment of vertebral compression fractures