Traumatic paraplegia: evaluation of fuctional recovery of thoracolumbar fracture fixation in relation to preoperative neurological deficit
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 2
Abstract
Fractures of thoracolumbar spine are common injury with variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient & fracture.Our aim was to assess the function outcome after surgical treatment of fracture at thoracolumbar level treated with pedicle screw fixation with laminectomy & cord decompression.Materials and methods: This wasa retrospective randomized study comprised 50 patients with fracture thoracolumbar area treated with titanium pedicular screw fixation with laminectomy & cord decompression. The patients were followed up at 2nd week, 1month, 3months, 6months, 9months and 1year after surgery. The assessment of spinal instability according to Denis three column concept &criteriaMcAfee Et al & assessment of neurological improvement as per Frankle grading system in each follow up visits.Results:At the end of 1 years of studywhen decompression done within 1st week in incomplete paraplegia 80% of the patients showed return of grade 3 power. In complete paraplegia cases, 11% of the patients had return to power upto grade 3 when decompression done within 1 week whereas no cases return of grade 3 power when decompression done after 2nd week.Conclusion: After recovery from spinal shock, the earlier the surgical decompression done, the better the neurological and bowel/bladder function recovery both in complete and incomplete paraplegic cases. Reduction is better and easy and less time consuming in early decompression than in late.
Authors and Affiliations
R S Bajoriya, shailendra Saiyam, Swami Pravin, Anand Nema
Keywords
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