A retrospective study on functional and radiological outcome in patients operated for mid lumbar fractures of spine admitted to the spinal disorders unit of CMC Vellore from 2001- 2010

Bhim Bahadur, Harijan (2013) A retrospective study on functional and radiological outcome in patients operated for mid lumbar fractures of spine admitted to the spinal disorders unit of CMC Vellore from 2001- 2010. Masters thesis, Christian Medical College, Vellore.

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Abstract

OBJECTIVES: To assess neurological recovery using ASIA impairment scale , To assess functional status using FIM (Functional Independent Measure) in paraplegic patients and Denis Work scale in all patients.,To assess loss of sagittal alignment correction and loss of translational deformity using Cobbs angle and Translation ratio. To determine the role of surgery to reduce, stabilize and maintain the alignment in the mid lumbar region. METHODS: A review of all the patients from the spinal disorders Unit of the department of Orthopedics , Christian Medical College and Hospital vellore, diagnosed and operated with mid lumbar fractures (l2,l3,l4) over a period of 10 years, was performed. Approval of the institutional review board was obtained. The charts, radiographs at the time of admission, CT scans were reviewed. Patients without adequate or available radiographs were excluded. ASIA scale was used to determine neurological status. Cobbs angle and Vertebral translation ratio was used to measure loss of correction of kyphosis and translation after surgery. Denis work scale and pain scale as well as FIM was used to measure. The data was entered in SPSS version 16 and statistician was involved in statistical analysis. Basic descriptive analysis , Chi Square test and T tests were used for analysis. RESULTS: The mean age was 29.6. Range (16 - 57 years). More than 80 percent of the patients were less than 40 years of age (93.8%). The sub group (21- 30) had the highest number of patients. (31.2%) Thirty (93.75%) were male and 2(6.25%) were females. 65% percent were manual labourers or farmers. About 60% of the patients were married. Fall from injury was the most common of mechanism of injury 26 (81.2%) followed by Road traffic accident 4 (12.5%) and fall of heavy object on the back 2 (6.2%). Most of the patients were labourers and farmers injuries were related to work ( fall from coconut/palm tree or fall in into the well). More than half the patients 17 (53.1%) had associated injuries. And lower limb injuries were most common 10 (58.82%), followed by upper limb 3 (17.64%). 3 (17.64%) patients also had multi system injuries. 9.4% of patients also had multi system injuries. L2 was most frequently involved 20 (62.5%) followed by L3 9 (28.1%) and L4 3 (9.4%) Burst fracture was the most common fracture type 19 (59.4%) followed by flexion distraction injury 6 (18.8%), fracture dislocation 4 (12.5%) and Compression 3 (9.4%)22 (68.75%) patients had neurological deficit and 10 (34.4%) were neurologically intact. 9(28.13%) patients had complete deficit where as 13(40.62%) had partial deficit . Most patients had neurological recovery and very few had loss of correction of deformity and most of them were functional independently. CONCLUSIONS: 1. The operative stabilization allows early rehabilitation in patients with fractures of lumbar spine. 2. The choice of injury is dictated by the severity of injury. The correction achieved in sagittal plane as well as reduction of translation achieved are maintained at the follow up averaging more than three years.

Item Type: Thesis (Masters)
Uncontrolled Keywords: functional and radiological outcome ; mid lumbar fractures ; spine ; spinal disorders ; CMC Vellore ; retrospective study.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 21 Sep 2017 02:46
Last Modified: 27 Mar 2020 07:17
URI: http://repository-tnmgrmu.ac.in/id/eprint/3060

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