A Prospective study of Functional Outcome of Dorso-Lumbar Spine Fractures Treated by Posterior Stabilization with Pedicle Screw Fixation

Udaya Kumar, D (2021) A Prospective study of Functional Outcome of Dorso-Lumbar Spine Fractures Treated by Posterior Stabilization with Pedicle Screw Fixation. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.

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Abstract

INTRODUCTION: Spine fractures have become very common and the numbers are increasing due to increase in use of automobiles and work-place trauma. If left untreated, spine fractures may lead to significant morbidity and mortality. Thoraco-lumbar junction being a junction between the less mobile thoracic and highly mobile lumbar spine, this region is more vulnerable to injury. The main goals of treatment are to stabilize the spine and rehabilitate the patient as much as possible to the pre-injury level. AIM OF THE STUDY: In this study we aim to evaluate the functional and radiological outcome of dorso-lumbar spine fractures treated by posterior stabilization with pedicle screw fixation. MATERIALS AND METHODS: This is a prospective interventional study done at the Department of Orthopaedics at Govt. Mohan Kumaramangalam Medical College and Hospital at Salem, between October 2018 and October 2020. Twenty-five patients with dorso-lumbar spine fractures who were willing to take part in the study were included in this study. All the patients were treated by posterior stabilization with poly-axial pedicle screw fixation. All the patients were followed up for a minimum of 12 months. All 25 patients were available for follow-up till 12 months. OBSERVATION AND RESULTS: The mean age of the study group was 38.4 years, males being most common (68%). The most common mode of injury was fall from height (68%) followed by road traffic accident (32%). The most frequently fractured vertebra was D11 followed by L1 in our study. The most common type of fracture was type A (80%). At the end of one - year follow-up patients with Frankel A grading did not show any improvement. Out of 2 patients in Frankel C grade, 1 patient improved to Frankel D while the other remained the same. Out of 5 patients in Frankel D, 4 patients improved to Frankel E and 1 patient remained in Frankel D. All the patients in Frankel grade E maintained in Frankel E. There was no post-operative deterioration of neurological status in any of the patients. The preoperative Beck’s index was 0.607 which improved to 0.72 at 1-year follow-up. The preoperative regional kyphotic angle was 16.56° which improved to 10.44° at 1-year follow-up with a mean correction of 6.12°. According to Denis Pain scale 44% of patients had no pain and 36% had occasional pain without need for pain medication at the end of 1 year. According to Denis Work scale 20% of the patients were able to return to their previous work/ heavy work, 24% were able to return to previous sedentary work or heavy work with restrictions and 28% were unable to return to previous work but were able to return to new sedentary work. 72% of patients had no complications. 12% had pressure sore, 8% had superficial infection and 8% has urinary tract infection. CONCLUSION: From our study we conclude that posterior stabilization with pedicle screw and rod system is an excellent option for dorso-lumbar spine fractures. It resulted in good improvement in post-operative regional kyphotic angle and Beck’s index. Also, the post-operative neurological status has improved in a significant number of patients and also the over-all functional outcome of patients according to the Denis pain and Denis work scale has shown improvement.

Item Type: Thesis (Masters)
Additional Information: 221812360
Uncontrolled Keywords: Thoraco-lumbar spine fractures, Pedicle screw fixation, posterior stabilization, Kyphotic angle, Beck’s index.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 17 May 2021 16:42
Last Modified: 08 Jan 2022 13:17
URI: http://repository-tnmgrmu.ac.in/id/eprint/16930

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