Study of steffee fixation in spinal trauma

Abstract

Background: The management of thoraco lumbar and lumbar injuries depends on the mechanical and neurological problems due to injury of bone, ligaments, disc and cord. The steffee system of transpedicular spinal stabilization, when used with correct operative technique and a sound knowledge of the morphology of pedicles at various levels is a good, cost effective implant which can be adapted for usage in all types of thoracolumbar injuries with minimal complications. Materials and Methods: In a prospective study conducted in the Postgraduate Department of Orthopaedics, Pudukkottai Government Medical College and Hospital, Tamilnadu over a period of 2 years. Fifty cases, both male and female in the age group of 20 to 60 years, who had undergone steffee fixation for various types of spinal injuries with neurological deficit were included. The results were analyzed according to neurological improvement as per Frankel's grading, the complications and the duration of hospital stay in both the groups. Results: In this series 80% of patients had spinal injuries at the thoraco lumbar [D12 – L1] level. Burst Fractures and fracture dislocation were the two most common types of fractures and accounted for about 90% of the spinal injuries in this study. Out of 50 cases, 44 patients the results were good. Of the remaining 6 patients screw breakage occurred in 2 patients after the injured vertebrae had fused. Implant backing out was seen in two patients, but the K angle was maintained and the injured vertebrae had fused. Only in one patient the result was poor as there was screw breakage in the first month which led to loss of spinal stabilization. Conclusion: The steffee system of transpedicular spinal stabilization, when used with correct operative technique and a sound knowledge of the morphology of pedicles at various levels is a good, cost effective implant which can be adapted for usage in all types of thoracolumbar injuries with minimal complications.