Neurological Outcomes of Transpedicular Fixation in the Management of Thoracolumbar Burst Fractures

Abstract

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.