Comparative study of neurological recovery following anterior and trans pedicular decompression with instrumentation in thoracolumbar spine fractures with neurological deficits
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 4
Abstract
Background: Spinal trauma is becoming a common problem in today's orthopaedic practice, more so in this era where the individuals are more at risk due to high energy trauma. An undiagnosed or sub-optimally managed spine injury can result in a neurologic deficit and permanently impair a patient's function and quality of life. The vast majority of these injuries have been shown to affect the motion segments between T11 and L2 that comprise the thoracolumbar junction. Early surgical decompression with instrumentation reduces hospital stay, facilitates early recovery and prevents prolonged morbidity, so there is an urgent need for exploring possibilities of surgical stabilization, early mobilization and rehabilitation of patients Materials and methods: All the patients with thoracolumbar spine fractures who had undergone surgical decompression at the department of orthopaedics in Father Muller Medical College, Mangalore from June 2016 to August 2017, were included in this study and followed up at 3 months, 6 months and 1 year after surgery. Results: A prospective follow up study of one year duration with a sample size of 30 patients were incuded. The patients with single level thoracolumbar spinal fractures selected after a pre-operative CT/MRI, undergoing surgical decompression at Father Muller Medical College & Hospital would be evaluated and assessed post-operatively for neurological recovery using ASIA (The American Spinal Injury Association) at 3rd month, 6th month and at last follow-up at one year. Anterior decompression with instrumentation and posterior decompression with instrumentation are both effective ways to stabilise spine but there is significantly better neurological recovery in anterior group compared to posterior group. Conclusion: In our study functional outcome was assessed using Denis work scale at last follow-up. Out of 8 paraplegics 3 did not improve and completely wheel chair bound at 1 year and were completely disabled (W5).Out of 22 incomplete paraplegics 1 was completely disabled at 1 year (W5). Rest of the patients were able to return to some occupation at 1 year but none of them were able to return to their previous occupation with no restrictions. 3 out of 14 (21.42%) in anterior group and 5 out of 16 (31.25%) in posterior group were able to return to their previous occupation but with restrictions.
Authors and Affiliations
Dr. Acharya Rajneesh, Dr. Edward Nazareth
Keywords
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- EP ID EP480906
- DOI 10.22271/ortho.2017.v3.i4b.13
- Views 139
- Downloads 0
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