Evaluation of Thoraco Lumbar Fractures of Spine Managed With Pedicle Screw Fixation
Journal Title: Journal of Medical Science And clinical Research - Year 2014, Vol 2, Issue 12
Abstract
Background: The thoracolumbar junction is the most common area of injury to the spine. The forces through kyphotic stiff spine (thoracic) spine switch abruptly into the mobile lordotic lumbar spine at the thoracolumbar junction. Goals of treatment are to maintain the stability & balance of spine without pain along with good neurological function and maximum mobility of spine. This study evaluates the effectiveness of pedicle screw instrumentation in various fractures around the TL spine to overcome the complications encountered in the conservative line of management of these fractures. Materials & Methodology: 20 cases of fractures around the TL spine were operated with posterior pedicle screw fixation one or two level above and below the fracture from November 2012 to March 2014. The cases were followed up for a mean of 7.5 months with radiological and neurological evaluation. Results: The average age groups of the patients studied were 19 to 50 years majority were males, fall from height being the predominant mode of injury involving the T12 and L1 level. Commonest type of fractures are burst unstable fractures. The parameters like radiological sagittal angle & index were recorded before & after the surgery. The ASIA score is used for the grading of neurology condition. Follow-up was done for a minimum of 6 months where sagittal angle reduction achieved was 10.85° at final follow-up from 24.751 preoperatives. The sagittal index achieved at final follow-up was 71.8% compared to the pre-operative mean of 50.6%. The neurological improvement was regarded to be fair enough for the type of injury sustained and fixation achieved. Conclusion: After applying the posterior instrumentation resulted in a reasonable correction of the deformity with a significant reduction in recumbency associated complications; the limiting factor being the small study group and short follow-up period
Authors and Affiliations
Krishnamurthy M. O
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