A Comparative Study of Thoracolumbar Spine Fractures Treated by Conservative Management versus Pedicle Screw Fixation
Journal Title: Saudi Journal of Medicine - Year 2018, Vol 3, Issue 12
Abstract
Spinal trauma is very common in orthopedic practice. There is a debate as to whether the surgical or conservative approach is more effective in the treatment of spine fractures. We in the present study tried to evaluate the outcomes of patients with spinal fractures treated with the conservative treatment and surgical treatment and overall outcome of treatment in the patients. Methods: In this prospective cross-sectional study conducted in the Department of orthopedics, MGM hospital attached to Kakatiya Medical College. A total of 30 patients were included in the study of which (n=15) patients were treated with conservative treatment based on the presentation of fractures and similarly (n=15) were taken for operative treatment depending on the type of fractures. A Detailed history of the injury was obtained they were clinically and radiologically evaluated for the thoracolumbar fracture. The radiographs included the anteroposterior and lateral views. Laboratory investigations were carried out before the surgery. CT and MRI scans were carried out to evaluate the relationship and instability of the spine. Results: The L1 vertebra was the most common to get fractured and most of the fractures (74%) were appeared at T12 and L1. AO type, A fractures were only studied with the majority of the fractures (66.6) were falling into AO type A3 (burst fractures). DENIS pain scale scores in conservative treatment, category 8 (53.3%) of patients were in the P3 category similarly in operative treatment 46.67 % of patients were in P1 category. Those managed conservatively 60% could return to their original jobs which could be either heavy work or sedentary work, and remaining 40% could not be able to return to their activity but works in less challenging jobs of those managed operatively 86% of people could able to work in their original jobs and 13% of people changed their working function to less challenging jobs. Conclusion: The study shows that pedicle screw-rod instrumentation is an excellent method for improving the clinical and radiological parameters (correcting kyphosis) in the operatively treated group. Based on the findings of this study considering the complications and cost associated with the surgical procedure, we advocate operative spinal deformity reduction and posterior short segment stabilization with pedicle screw-rod instrumentation for patients with AO type A3 (burst fractures) fractures without neurological deficit, especially in those with significant kyphotic deformity
Authors and Affiliations
Dr. Dodda Prasad Reddy, Dr. Kovvuru Kranthi Kiran
Keywords
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