Functional and Radiological Outcome of Thoracolumbar Burst Fracture

Pandiyan, Loganathan (2019) Functional and Radiological Outcome of Thoracolumbar Burst Fracture. Masters thesis, Christian Medical College, Vellore.


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OBJECTIVES: To assess the functional outcome (neurological recovery, Denis pain scale, Denis work scale) and radiological outcome using various radiographic parameters in patients treated for thoracolumbar burst fracture. METHODS: Neurological recovery assessed using ASIA scale in patient with neurological deficit. Denis pain scale and Denis work scale was used to assess the pain and return to work during follow up. Radiographic parameters were measured using ZFP. Quantitative variables will be summarized using mean and standard deviation for normally distributed variables or median and IQR for skewed variables. Paired samples t-test will be used to assess the changes in the angle of kyphosis between immediate postop or at the time of injury and the follow up. For all the analysis, 5% level of significance will be considered to be significant. RESULTS: There was no improvement in neurology in patients with complete deficit at the time of injury. No neurological deterioration due to surgical fixation. Loss of correction of kyphosis is less with posterior instrumentation with screw inserted through fracture site. There was progression of kyphosis all patients treated by non-operative methods. The loss of correction of kyphosis (operative) or the progression of kyphosis (non-operative) methods did not have any correlation with functional outcome. CONCLUSION: Though BURST FRACTURE is a very common fracture at the thoracolumbar junction the ideal management still remains controversial. In patients with complete neurological deficit surgical fixation helps in early mobilization, rehabilitation and improvement in the quality of life. If they are managed non-operatively they can be managed with plaster cast providing support for early mobilization. Though there is loss correction of kyphosis at follow up in operative group and progression of kyphosis in the non-operative group, there was no correlation with the functional outcomes in terms of pain (Denis pain scale) or return to work (Denis work scale). No single classification system can be applied to decide on the ideal management of burst fracture. AO classification is an useful tool to describe the morphology. LOAD SHARING CLASSFICATION can be used to decide on the type of approach.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Computed Tomography, Magnetic Resonance Imaging, Thoraco- Lumbar junction, Functional Independence Measure, Thoraco -Lumbar Injury Association Classification and Scoring system, Randomized Control Trial, Road Traffic Accident, Zero Foot Print, Deep Vein Thrombosis, ICD.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 01 Sep 2019 09:15
Last Modified: 01 Sep 2019 09:15

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