Outcome of Unstable Thoracolumbar Fracture Following Long Segment Posterior Fixation

Abstract

Introduction: Fractures of the thoracolumbar region are the most common injuries of the vertebral column and burst fractures are the most frequent. The purpose of this study was to see the radiological and functional outcome after long segment posterior fixation in unstable thoracolumbar spine injury with incomplete neurological deficit.
 Methods: A total of 146 cases were included in this prospective case series from January 2014 to December 2018 through non randomized purposive sampling. All the patients were operated with long segment posterior fixation and postero-lateral fusion by Autogenous cancellous bone graft. Postoperative functional outcome was assessed both clinically by ODI, VAS, ASIA and radiologically by Bridwell criteria. Postoperative follow up was conducted at 2nd, 6th,12th and finally 6 monthly.
 Results: The mean Cobb angle at pre-operative was 21.5 ±8.9 and at final follow-up was 11±4.57 in this study (p-value<0.05). At final follow up 1 grade improvement occurred in 116(79.5%) patients and 2 grade improvement in 36 (20.5%). Regarding ODI and VAS, moderate disability (25%) with mild pain (16%) was found at final follow up with a Bridwell fusion grade II (48%).
 Conclusion: Long segment transpedicular screw fixation in unstable thoracolumbar spine injury with incomplete neurological deficit is an effective method of treatment. This method enhances neurological and functional recovery with an acceptable fusion rate
 J Bangladesh Coll Phys Surg 2021; 39(2): 114-122

Thoraco-lumbar Burst Fractures among Patients Admitted to Spine Unit of the Department of Orthopedics of a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…The time interval from injury to surgery time was 5.5 days for one of the studies, 18 and 14-21 days for the other one. 14 It was 2.87±1.97 days in our study and 1 day in a study. 23 Studies have shown better outcomes with less interval from injury to surgery.…”

“…The final VAS score in our study was 14.37±12.08 which was similar to the final VAS score of 16.4±8.9 in the study. 14 The VAS score was lower in other studies. 11 , 26 A total of 27 (90%) cases in our study had mild pain and 3 (10%) had moderate pain at the final follow-up.…”

“… 18 Other studies also had similar finding similar age groups. 11 , 14 The cause of burst fractures varies. Fall was the most common mode of injury in our study.…”

“… 11 It was a very high number of cases of fall injury in another study. 14 In western countries, road traffic accidents account for the most common cause of injury. 10 , 12 …”

“…Most of the patients were manual workers by occupation according to a study. 14 As agriculture is the main source of income in our country and male often go out to farms and the jungle to work, it might be the main reason for their injury.…”