Spine fractures in active duty soldiers and their return to duty rate

To evaluate the outcome of thoracolumbar spine fractures in active duty soldiers, we conducted a retrospective review of 23 soldiers followed at a single institution. Twenty-two charts were available for review. The average age was 31.9 years (range, 19-49 years), and the average follow-up was 3.6 years (range, 2-11 years). There were 20 males and 2 females. All injuries except one occurred between 1990 and 1994, and all were treated by a single surgeon. We attempted to correlate five independent variables with regard to whether the patient returned to his or her previous duty or was required to undergo a medical evaluation board to determine fitness for duty. The variables included military rank, physical job demands, fracture type, initial neurological status, and initial treatment (operative versus nonoperative). Fourteen of the 22 soldiers (64%) underwent medical evaluation boards, whereas 8 (36%) returned to their previous duties. We found a strong correlation between increasing military rank and return to preinjury duties. As expected, physical job demands correlated strongly with eventual disposition, in that soldiers in jobs with low physical demands were more likely to be retained on active duty in their present position. Neurologic status (except motor deficit), type of fracture (except fracture-dislocation), and initial treatment did not correlate well with eventual disposition.