الفهرس 
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Abstract
Pathological fractures are fractures that occur in diseased bone. The most common causes of pathological spine fractures are osteoporosis, tumors and infections. These fractures that can cause pain, neural compromise, and deformity.
Radiography offers an initial assessment of the degree of kyphosis, collapse, lytic or sclerotic or mixed destruction or subluxation of the spine. The inter-vertebral disc is usually preserved in patients with neoplasm. This helps in differentiating tumors from pyogenic infection where the disc is frequently destroyed along with the adjacent vertebral body. Plain x-ray, CT scan and MRI are standard evaluation tools for any pathological spine fracture.
The aim of this study to evaluate clinical and surgical outcome of management of pathological dorsal and lumbar spine fractures.
In our study, 50 patients with dorsal and lumbar pathological fractures were divided according to the cause into three groups: 1) group A (21 patients): includes patients with osteoporotic fractures, 2) group B (18 patients): includes patients with neoplastic fractures, 3) group C (11 patients): includes patients with pathological fracture due to infection. They were operated upon by different surgical modalities.
All surgical methods dealt with fractured vertebrae aiming to either augment the fragile bone; if not severely fractured; or complete excision of pathologic vertebrae if it is severely deformed or if the underlying disease has the character of dissemination or progressive growth (as in some tumors and infections).
In osteoporotic spine fractures, vertebroplasty was done in in nine patients who had no neurological deficit. The vertebral height loss was not more than 50% with no bony canal compromise with intact vertebral cortex. Kyhpoplasty was done in four patients had no neurological deficit. The vertebral height loss not more than 70% with no bony canal compromise with disrupted vertebral cortex. Laminectomy and instrumental fixation were done in eight patients who clinically presented and radiologically documented with neural compression.
In neoplastic pathological fractures, vertebroplasty was done in ten patients who had the same previous clinical and radiological criteria in osteoporotic group. Posterior decompression and instrumented fixation was done for five patients whose clinical examination showed recent neurological deficit. The radiological investigations showed vertebral canal compromise and neural elements compression without significant kyphotic deformity. Corpectomy and fixation was done for three patients who had recent neurological deficit. Their radiological investigations showed vertebral canal compromise, neural elements compression and significant kyphotic deformity.
In infection group, posterior decompression and fixation was done for nine patients who had recent neurological deficit without significant kyphotic deformity. Corpectomy and fixation was done for two patients who had recent neurological deficit with significant kyphotic deformity.
In our study, clinical outcome was measured using ASIA impairment scale, VAS and Karnofsky scale. Each patient was evaluated by this scale preoperatively and was compared with the same scales measured immediate postoperatively and after 3 months, 6months and one year postoperatively.