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Abstract
Introduction Non-surgical management of non-neurological thoracic or lumbar spine (TL) fractures seems to provide good results in the civilian population, leading to return to work in most cases. However, data on the military population are limited, particularly regarding return to duty. This study aimed to describe a population of French military patients with traumatic non-neurological TL fractures and the outcomes of non-surgical management regarding operational capacity.
Materials and methods This retrospective single-centre observational study used data from military patients followed for non-neurological TL fractures, from the date of the trauma or after treatment in another civilian or military care facility. Medical fitness status at 1 year was the primary outcome. Medical fitness status at 1 year was defined as unrestricted resumption and restricted resumption in cases of return to duty in a different role or in the previous role with restrictions.
Results Between January 2010 and December 2020, 93 patients presented with non-neurological traumatic TL fractures at Sainte-Anne National Military Hospital. Fifty-four records met the inclusion criteria. Falls from high heights (27.8%, n=15) and road accidents (24.1%, n=13) were the most common traumatic mechanisms. The remaining 77 injuries were compression fractures, predominantly at the thoracolumbar junction. One year after trauma, 90.7% of patients (n=49) had returned to duty, and 77.8% (n=42) were free from medical restriction. The median duration of incapacity (MDI) was 173 days. Age significantly affected medical fitness at 1 year (p=0.019); however, it did not affect the MDI. Polytrauma was significantly associated with a lower resumption rate at 1 year (53.3%, p=0.007).
Conclusion Non-surgical management of non-neurological TL fractures allowed unrestricted return to duty in this population. These clinically relevant trends have led to perspectives for defining non-surgical treatment indications, means and goals.
- Spine
- Military Personnel
- Neurosurgery
- TRAUMA MANAGEMENT
- REHABILITATION MEDICINE
- ANAESTHETICS
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Footnotes
Contributors JBL, PJC, CDS, LA, AD and CJ were involved in the planning, conduct and reporting of the work. LA, AD and CJ provided oversight to set research objectives and supported choice of appropriate method. Data search was conducted by JBL and CDS. Analysis was conducted by JBL, PJC and LA with review and comments from AD and CJ. JBL wrote the first and final drafts of the manuscript. PJC, LA, AD and CJ reviewed the initial and final drafts of the manuscript. CJ is the guarantor of the study.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer-reviewed.
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