{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T20:40:08Z","timestamp":1748205608711,"version":"3.41.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>A fracture in the thoracolumbal junction may cause complete or incomplete damage to the spinal cord, conus medullaris or cauda equina and result in an isolated or mixed lesion of the upper and lower motor neurons causing leg weakness and urinary\/bowel\/sexual dysfunction. In this retrospective cross-sectional study, we aimed to describe electrodiagnostic and urodynamic findings after thoracolumbal fractures and determine potential discriminating factors. We identified 74 cases (mean age 42 years, range 16\u201379 years, 55 men) admitted to our institution between 2008 and 2018 for Th12, L1 or L2 vertebral fractures, and retrieved from their medical records available demographic, clinical, electrodiagnostic and urodynamic data. The most common electrodiagnostic findings in the lower limbs (<jats:italic toggle=\"yes\">n<\/jats:italic> = 40) were moderate-to-severe L3\u2013S1 (35%) and L5\u2013S1 (40%) lesions. As to the external anal sphincter (<jats:italic toggle=\"yes\">n<\/jats:italic> = 33), the most frequent findings were an incomplete cauda equina (39%) or conus medullaris (15%) lesion, followed by the combined upper and lower motor neuron lesion (12%). Only the fracture level (with peripheral damage) was statistically significantly associated with electromyography findings. Detrusor overactivity or underactivity was each present in 37 (50%) cases. Those with Th12 versus L1\u2013L2 fractures had higher odds of exhibiting detrusor overactivity; men had higher odds of using clean intermittent catheterization for bladder emptying than women. In summary, detrusor overactivity is common after fractures at the thoracolumbal junction and urodynamic findings are essential for proper diagnosis and selection of therapeutic approach. Combining urodynamic and electrodiagnostic studies is especially valuable in the presence of L1 fracture and lower urinary tract symptoms.<\/jats:p>","DOI":"10.1097\/mrr.0000000000000551","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T07:03:26Z","timestamp":1667372606000},"page":"355-358","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Lower urinary tract function in patients with fracture in thoracolumbal junction: an observational study"],"prefix":"10.1097","volume":"45","author":[{"given":"Ana","family":"Podbregar","sequence":"first","affiliation":[{"name":"University Rehabilitation Institute"},{"name":"Faculty of Medicine, University of Ljubljana, Ljubljana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaj","family":"Vidmar","sequence":"additional","affiliation":[{"name":"University Rehabilitation Institute"},{"name":"Faculty of Medicine, University of Ljubljana, Ljubljana"},{"name":"Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Koper, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Metka","family":"Mohari\u0107","sequence":"additional","affiliation":[{"name":"University Rehabilitation Institute"},{"name":"Faculty of Medicine, University of Ljubljana, Ljubljana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"R2-20250525","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1097\/00007632-199807010-00005","article-title":"The variation of position of the conus medullaris in an adult population.","volume":"23","author":"Saifuddin","year":"1998","journal-title":"Spine"},{"key":"R3-20250525","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1097\/01.brs.0000174116.74775.2e","article-title":"Magnetic resonance imaging study of the level of termination of the conus medullaris and the thecal sac: influence of age and gender.","volume":"30","author":"Soleiman","year":"2005","journal-title":"Spine"},{"key":"R4-20250525","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1080\/10790268.2002.11753630","article-title":"Prevalence of upper motor neuron vs lower motor neuron lesions in complete lower thoracic and lumbar spinal cord injuries.","volume":"25","author":"Doherty","year":"2002","journal-title":"J Spinal Cord Med"},{"key":"R6-20250525","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/S0022-5347(17)54147-6","article-title":"The neurophysiology of micturition: a clinical study of 550 patients.","volume":"127","author":"Blaivas","year":"1982","journal-title":"J Urol"},{"key":"R7-20250525","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/S0022-5347(17)55099-5","article-title":"Detrusor-external sphincter dyssynergia.","volume":"125","author":"Blaivas","year":"1981","journal-title":"J Urol"},{"key":"R8-20250525","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/S0090-4295(99)00553-1","article-title":"Association of level of injury and bladder behavior in patients with post-traumatic spinal cord injury.","volume":"55","author":"Weld","year":"2000","journal-title":"Urology"},{"key":"R9-20250525","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/B978-0-444-63247-0.00014-6","article-title":"Dysfunction of lower urinary tract in patients with spinal cord injury.","volume":"130","author":"Schurch","year":"2015","journal-title":"Handb Clin Neurol"},{"key":"R11-20250525","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1002\/nau.10052","article-title":"The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.","volume":"21","author":"Abrams","year":"2002","journal-title":"Neurourol Urodyn"},{"key":"R12-20250525","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1002\/nau.1018","article-title":"Protocol for clinical neurophysiologic examination of the pelvic floor.","volume":"20","author":"Podnar","year":"2001","journal-title":"Neurourol Urodyn"},{"key":"R14-20250525","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/mus.20696","article-title":"Epidemiology of cauda equina and conus medullaris lesions.","volume":"35","author":"Podnar","year":"2007","journal-title":"Muscle Nerve"},{"key":"R15-20250525","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1007\/s00586-011-2062-5","article-title":"Motor and bladder dysfunctions in patients with vertebral fractures at the thoracolumbar junction.","volume":"21","author":"Chen","year":"2012","journal-title":"Eur Spine J"},{"key":"R16-20250525","doi-asserted-by":"crossref","first-page":"E955","DOI":"10.1097\/BRS.0000000000000410","article-title":"Detrusor overactivity in patients with cauda equina syndrome.","volume":"39","author":"Kim","year":"2014","journal-title":"Spine"},{"key":"R17-20250525","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1038\/sj.sc.3100511","article-title":"The epiconus syndrome presenting radicular-type neurological features.","volume":"35","author":"Willems","year":"1997","journal-title":"Spinal Cord"}],"container-title":["International Journal of Rehabilitation 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