Management of fractures of thoracolumbar spine with pedicle screw fixation

Abstract

Objective: The spinal traumas are common and leading problem in orthopedic practice. In this study, we stabilize the cases of the unstable thoracolumbar spine injuries with decompression and pedicular screw instrumentation . Materials and Methods: This study was undertaken in the Department of Orthopedics in CG and Bapuji Hospitals attached to JJM Medical College, Davangere. Twenty adult patients with acute thoracolumbar injuries who gave the consent for surgery admitted during the study period were included as study sample. Patient selection was according to the inclusion and exclusion criteria and was surgically treated with pedicle screw and rod system (ZETA). Results: The standard deviation of the study group was 11.5 with mean age being 41 years. The most common vertebrae involved in this series were between T11 and L2 to the extent up to 50%. The average regional angle during preoperative stage was 16.50 ΁ 5.020 and 4.450 ΁ 4.150 during 1-year postoperative period. The mean difference of vertebral height between pre- and 12 th post-operative week was 8.8 mm, pre- and 24 th post-operative week was 7.95 and pre- and 1-year post-operative period was 7.95. Among all the subjects, 20% resumed the previous level of work or equal level of the physically challenging job. While 35% with little modification resumed the previous level of heavy work after 1 year of follow-up. After same period about 45% of subjects did not entertain any pain, whereas 30% felt occasionally, for which no medication was required. Conclusion: Findings of this study show that pedicle screw-rod instrumentation is an excellent implant system used in treatment of vertebral fractures. There is a very high statistical significant restoration of vertebral body height, mean regional angle and mean anterior wedge angle with this procedure in thoracolumbar fractures. Neurological recovery was seen significantly when all cases with neurological deficits were clubbed together.