Bi-Pedicle Fixation of Affected Vertebra in Thoracolumbar Burst Fracture
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 4
Abstract
Introduction: Burst fractures of the spine account for 14% of all spinal injuries and more than 50% of all thoracolumbar trauma. However, there is ambiguity while choosing the right treatment plan. Short Segment Pedicle screw Fixation (SSPF) has become an increasingly popular method of treatment of thoracolumbar burst fractures, providing the advantage of incorporating fewer motion segments in the fixation. Various biomechanical studies showed that the use of pedicle screws could achieve stable construct within short-segment fixation. Aim: To evaluate the efficacy of SSPF using longest possible screws in both pedicles of fractured vertebra. Materials and Methods: A retrospective chart review of 25 single burst thoracolumbar fracture patients, operated between May 2009 to 2015 in a tertiary care trauma center, was conducted. Preoperative and post-operative plain radiographs were evaluated for kyphotic angulations using the traditional Cobb method. Anterior Vertebral Height (AVH), Posteriors Vertebral Height (PVH) were measured preoperatively and immediate postoperatively. Average percentage loss of AVH and mid-sagittal height were calculated on preoperative and postoperative X-rays on follow up. Results: Fourteen men and 11 women with an average age of 42.92 years comprised the study population. Mean age at the time of operation was 34.5±14.2 years. Mean operation time was 168±72 (minutes). Average hospitalization time was 9±7 (days). Mean blood loss was 515±485 (ml). There were two cases of postoperative infection and implant failure each. A mean of 15.2° of kyphosis correction was attained from preoperation to post-operation (p<0.0001). Although, there was a 15° average improvement of kyphosis post-fixation, loss of correction over time was nearly 8°, resulting in a 7° mean correction of kyphosis. A mean loss of AVH on postoperative radiograph was 6.12% and maintained 12.4% at the time of review (p<0.001). Similarly, there was 32.8% mid-sagittal height loss at time of injury, which was improved to only 12.6% as compare to initial height loss (p<0.0001). Conclusion: In this study, we propose SSPF using longest possible screws in both pedicle of fractured vertebra. Bi-pedicular fixation gives significant radiological corrections.
Authors and Affiliations
Pravin Padalkar, Varshil Mehta
Keywords
Related Articles
- EP ID EP338448
- DOI 10.7860/JCDR/2017/17599.9714
- Views 83
- Downloads 0
Additional Virtual Reality Sitting Balance Training Using XBox Kinect™ in Patients with Neurological Disorders: A Pilot Study
Introduction: Sitting balance is a prerequisite to upper extremity function, standing and walking, which is affected in various neurological diseases. It is important to attain a good level of sitting balance before one...
Successful Surgical Outcome for an Endodontic Failure using Biodentine™ as Retrograde Restoration in Conjunction with Platelet Rich Fibrin (PRF) for Progressive Healing
Images in Medicine
Pharmacophore Mapping Approach for Drug Target Identification: A Chemical Synthesis and in Silico Study on Novel Thiadiazole Compounds
Introduction: Compounds containing thiadiazole moiety are cognized to possess with variety of clinical and therapeutic activity. Finding a suitable drug target for newly synthesized compounds remain a major bottle neck i...
Molecular Analysis of Dengue Virus Serotypes Circulating in Chennai, Tamil Nadu, India
ABSTRACT Introduction: Dengue fever is one of the most important arboviral infections all over the world. Globally, 50% of the human population is at risk of dengue virus infection. Circulation of more than one serotype...
Clinician Corner- A Simple and Efficient Modified Goshgarian Arch (“T” Arch) Appliance for Correcting Single Tooth Scissor Bite
Scissor bite is a rare form of malocclusion that is often accompanied by varying degrees of facial asymmetry. Correction and treatment of scissor bite in posterior teeth is a challenging job for an orthodontist. There ar...