BACKGROUND Transpedicular instrumentation systems have distinct advantages such as rigid segmental fixation, stabilization of the three columns, least failure at bone metal interface, early post-operative mobilization with efficient nursing care and least complications in the management of thoracolumbar burst fractures. The aim of this study was to analyze and compare the clinical and radiological outcome of thoracolumbar burst fractures treated by short segment and long segment transpedicular instrumentation. METHODS 34 patients who underwent posterior spinal stabilization with transpedicular instrumentation and posterolateral fusion for unstable thoracolumbar burst fractures with or without neurological deficit were included in the study. Load sharing classification (Gaines scoring) was used retrospectively to correlate fracture comminution and displacement with progression of the deformity and implant failure. Neurological evaluation was done and patients were graded according to ASIA (American Spinal Cord Injury Association) impairment scale as a part of physical examination. RESULTS The mean intra-operative correction in the short segment group was 14.4° and the loss of correction observed at the last followup evaluation was 7.48° with a final gain of 6.92°. The mean intra-operative correction in the long segment group was 19.77° and the loss of correction observed at the last follow-up evaluation was 6.61°. Final gain was 13.16°. On radiological evaluation, mean correction loss of 7.48 degrees and 3.4% implant failure was noted in the short segment group while the long segment group had 6.61 degrees of mean correction loss and no implant failure. There was no positive correlation found between Gaines score with progression of deformity. CONCLUSION Transpedicular fixation is a stable, reliable and less surgically extensive construct for addressing thoracolumbar burst fractures. About 6-8° loss of correction was observed with both short and long segment stabilizations in our study. Long segment has better results in terms of maintenance of reduction and final gain.

BACKGROUND The injuries involving the spinal cord are generally challenging to manage. Apart from correction of the bony structures, care should also be taken to ensure optimal neurological improvement. The neurological outcomes of transpedicular fixation in thoracolumbar burst fractures were evaluated in this study. METHODS 34 patients who underwent posterior spinal stabilization with transpedicular instrumentation and posterolateral fusion for unstable thoracolumbar burst fractures with or without neurological deficit were included in the study. Neurological evaluation was done and patients were graded according to ASIA (American Spinal Cord Injury Association) impairment scale as a part of physical examination. RESULTS In the short segment group four grades of improvement was found in 1 patient, three grades in 1 patient, two grades in 2 patients and one grade in 6 patients. In the long segment group, three grades of improvement were found in 3 patients, two grades in 2 patients and one grade in 2 patients. 1 of the grade D patient showed improvement within the grade and 3 patients did not show any improvement. Average ASIA motor score improved with treatment from 28.31 to 39.56 points (11.25) in short segment group and from 19.91 to 28.46 points (8.55) in long segment group. CONCLUSION The length of instrumentation does not seem to have any effect on the neurological outcome.

INTRODUCTIONIn around 300 enzymes, magnesium acts as a cofactor. These enzymes are involved in many biological reactions. These reactions are vital in cell metabolism, they regulate the blood glucose levels, useful in the synthesis of the proteins, also maintain the health of cardiovascular system etc. Bone contains around fifty percent of total body magnesium. And remaining quantity is found in soft tissues. As for other minerals, the levels of magnesium in the body are governed by excretion rate and absorption rate of the magnesium. ABSTRACTBackground: For proper functioning of energy system in the body, magnesium is essential. Deficiency of magnesium leads to hyperactivity of central nervous system and neuromuscular system. During surgery or before surgery or after surgery there can be alterations in the volume of fluid and composition of electrolytes. Objective was to study the effect of surgical trauma on serum magnesium levels in the early postoperative period. Methods: The present hospital based cross sectional study was carried out for a period of one year among 35 cases of surgical stress and 10 normal as control. Institutional ethics committee permission was taken prior to the start of the study. Individual informed consent was noted from each individual patient from both cases and controls. Data was recorded in the pre-designed pre-tested semi structured questionnaire for the present study. Serum magnesium level was assessed in both the groups and compared. Results: It was found that the preoperative magnesium levels were more as compared to postoperative levels among both the types of stress groups but the difference was not found to be statistically significant. (p > 0.05) Among the mild to moderate stress groups, it was found that the preoperative magnesium levels were more as compared to postoperative levels among all the age groups but the difference was not found to be statistically significant. (p > 0.05) Among the severe stress groups, it was found that the preoperative magnesium levels were more as compared to postoperative levels among all the age groups but the difference was not found to be statistically significant. (p > 0.05). Conclusions: Occurrence of postoperative hypomagnesaemia plays a minor role in normal surgical convalescence.