Early Short Segment Pedicle Screw Fixation Including Fractured Vertebra of Thoracolumbar Burst Fracture with Incomplete Spinal Cord Injury

Abstract

Background: Fractures of the thoracolumbar region are the most common injuries of the vertebral column; among them burst fractures are the most frequent. Several studies were done to see the surgical outcome of thoracolumbar burst fracture hence surgery was recommended for a better outcome. So, the current study aimed to evaluate the clinical, functional, and radiological outcome of short-segment pedicle screw fixation including the fractured vertebral body. Objectives: The primary aim of this study is to comprehensively evaluate the functional and radiological outcomes of early short-segment pedicle screw fixation, particularly in cases involving fractured vertebrae in thoracolumbar burst fractures accompanied by incomplete spinal cord injuries. Materials & Method: In this prospective observational study, 31 cases were included between April 2017 and July 2018 through non-randomized purposive sampling. All patients, aged 15 to 60 years, underwent posterior decompression and short-segment pedicle screw fixation, including the fractured vertebral body, within 21 days of the fracture. Postoperative functional outcomes were clinically assessed using the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), American Spinal Injury Association (ASIA) scale, Denis Work Scale, and radiologically evaluated by Cobb's kyphotic angle, kyphotic deformation, Beck index, and Bridwell criteria. Postoperative follow-ups were conducted at the 6th, 12th, and 24th weeks. Results: In this study, 31 cervical spinal injury patients underwent operative treatment with a 3 to 12-month follow-up. Most were day laborers (35.48%), experiencing falls from height (80.65%), mainly at L1 (54.84%). Initial ASIA grade D improved to E (54.58%). Postoperatively, significant improvements in kyphotic angles, Beck index, and vertebral height were noted, with some correction loss at the final follow-up. Complications occurred in 22.58% of cases, including per-operative hemorrhage, dural tear, .......