Predicting Voiding Function after Thoracolumbar Burst Fracture

Objective: To study factors associated with bladder dysfunction after thoracolumbar fracture. Methods: We retrospectively reviewed the records of 41 patients (22 men, 19 women) admitted to MacKay Memorial Hospital with thoracolumbar burst fractures from January 2001 to December 2005. The variables studied included cause of injury, duration of hospitalization, time from injury to operation, and bulbocavernosus reflex (BCR) function on the day of admission. Bladder function was re-evaluated six months after surgery. Descriptive statistics for continuous variables were calculated and reported as mean ± standard deviation (mean ±SD). Categorical variables were described using frequency distributions. The t-test was used to analyze continuous variables and chi-square test or Fisher's exact test was used for categorical variables. The effect of variables on the outcome of bladder function was evaluated by logistic regression using a generalized linear model. Results: At follow-up, 17 patients (41%) had bladder dysfunction, and 24 patients (58%) had normal bladder function. The risk of bladder dysfunction six months after surgery was significantly lower among patients whose initial BCR was positive (OR 0.225, 95% CI 0.060 to 0.848, P = 0.028) or whose American Spinal Injury Association (ASIA ) score was D or E (OR 0.353, 95% CI 0.175 to 0.711, P = 0.004). Conclusions: An initial neurologic examination, including evaluation of BCR function and ASIA scale scores, is useful in predicting bladder dysfunction following thoracolumbar burst fracture.

並列關鍵字

vertebral fracture ； neurogenic bladder ； spine

國際替代計量

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