Title : Short segment pedicular fixation for thoracolumbar fractures with use of screws in fractured vertebrae
Abstract:
Introduction: It has been estimated that 6% of all fractures involve the spinal column, approximately 90% occurring within the thoracic or lumbar regions. Thoraco-lumbar injuries classically exhibit a bimodal distribution, with peaks among males under 30 years of age and in the geriatric population. Short segment pedicular fixation is a best way of fixation of these fractures.
Aims: To assess clinical outcomes of the management of acute thoraco-lumbar fractures by short segment pedicle screw fixation with screws in the fractured vertebrae.
Methods: 32 Adult patients with acute thoraco-lumbar injuries admitted under Spine surgery unit at FMMCH, Mangalore, India.
Results: 24 out of 32 patients had no neurological deficits and categorised under ASIA-E accounting for 75% of the cases. Vertebral body height was restored to 70.25% from 40.09%. Degree of segmental kyphotic angle restored to 8.370 from 15.32 0. The Oswestry disability index, pre-operatively was an average of 44.28 % reduced to 32.52%. Visual analogue score calculated was 7, which shows moderate to severe pain which improved during rehabilitation.
Conclusion: The technique of short segment pedicle screw fixation with screws in fractured vertebrae was found to be safe as our study did not show worsening of the preoperative neurological status in any patients with ASIA C and above. The procedure resulted in smaller incision, lesser operative time and less blood loss, adequate indirect decompression of the spinal canal. The outcome in terms of improvement of ASIA impairment scale was determined by the initial injury. Hence it was found to be an effective and safe technique which retains the biomechanical stability as compared to the long segment fixation while requiring smaller incision, lesser operative time, less blood loss.
