Unstable thoracolumbar spinal injuries treated by pedicle screw fixation: A short-term evaluation

Abstract

Context: The incidence of spinal cord injury, especially in thoraco-lumbar junction has increased substantially owing to increase in high energy blunt trauma. Since it tends to affect younger population, they become a huge emotional, social and financial problem to the patient and their families. This study evaluates the use of pedicle screw fixation for preservation of remaining spinal cord function, restoration of spinal alignment, and achievement of pain-free fracture site, early mobilization and maximization of neurological recovery. Aims: Assess functional and radiological outcome after pedicle screw fixation and analysing the complications. Settings and Design: Institution based prospective, longitudinal study. Materials and Methods: Pedicle screw fixation of 10 adult patients with unstable thoraco-lumbar spinal trauma and their follow-up. Statistical Analysis Used: Patients evaluated pre and post operatively, both clinically (ASIA scale) and radiologically at regular intervals. Results: Out of 10 patients, according to the ASIA impairment scale, during pre-operative period, 50% were graded as grade A, 20% as grade B, and 30% as C. During last follow up, grade A was 50%, grade B was 10%, C was 20%, D was 20%. 80% of the patients had shown no complications, only pressure sore (20%) and wound dehiscence (10%) were observed in the study group. Conclusions: Pedicle screw fixation is a better option for early ambulation and recovery. It achieves reduction and stability in both anterior and posterior column injuries. Earlier the intervention better the prognosis. Large scale trials are needed to assess the true magnitude of the problem and their management in the developing world.