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Outcome of Long Segment Transpedicular Screw Fixation in Unstable Thoracolumbar Spine Injury with Incomplete Neurological Deficit

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DOI: 10.4236/jbm.2020.83015    19 Downloads   52 Views
Author(s)
Shah Md. Rezaul Karim1, A. K. M. Shahidur Rahman2, Syed Abdus Sobhan3, Md. Shahidul Islam Akon4, Muhammad Akter Hossain5, Ashraf Ali6, Shah Newas7, Md. Ruhul Quddus8, Md. Moshiur Rahman Mollick9

Affiliation(s)

1Department of Surgery, Sheikh Hasina Medical College Hospital, Habiganj, Bangladesh.
2Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
3Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
4Department of Orthopaedic Surgery, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh.
5Department of Anatomy, Chandpur Medical College, Chandpur, Bangladesh.
6Department of Cardiology, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh.
7Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh.
8Department of Biochemistry, Pabna Medical College, Pabna, Bangladesh.
9Department of Orthopaedic Surgery, Sheikh Hasina Medical College Hospital, Habiganj, Bangladesh.

ABSTRACT

Background: Long segment transpedicular screw fixation in thoracolumbar spine injury has gained popularity in the last decades as it provides immediate stability, prevents further risk of complications and allows early mobilization of patient. Objectives: Evaluation of clinical and functional outcome after long segment transpedicular screw fixation in unstable thoracolumbar spine injury with incomplete neurological deficit patients. Methods: This quasi experimental study was conducted at Dhaka Medical College and Hospital (DMCH), Dhaka, Bangladesh from January 2016 to December 2017. A total of twenty four (24) patients with traumatic unstable fracture of the thoracolumbar spine with incomplete neurological deficit underwent long segment transpedicular screw fixation were included in this study. Clinical and radiologic outcomes were assessed pre-operatively and post-operatively. Results: A total of 24 patients aged between 20 - 60 years of both sexes (Male-21, Female-03) were included in this study. Their mean (±SD) age was 33.12 (±8.57) years. Most of them were farmer [09 (37.5%)] and day labour [08 (33.33%)]. Motor vehicle accidents were the most common [16 (66.67%)] cause of injury and then fall from height [08 (33.33%)]. The most common level of injury involved was L1-10 (41.67%) patients, followed by L2-07 (29.17%), T12-05 (20.83%) and T11-02 (8.33%) of the study patients. Burst fracture was the commonest [22 (91.67%)] type of fracture followed by Chance fracture [02 (8.33%)]. Pre-operative mean (±SD) Cobb angle, Kyphotic deformation of vertebral body, Beck index and vertebral compression deformity were 21.83 ± 4.5 degrees, 22.09 ± 4.40 degrees, 0.78 ± 2.65 and 0.18 ± 0.93 mm respectively, after procedure which were significantly (p < 0.05) decreased to 12.5 ± 3 degrees, 11.50 ± 3.5 degrees, 0.86 ± 0.40 and 0.11 ± 0.00011 mm respectively at final follow up visit. Pain was significantly (p < 0.001) decreased, while neurologic function and working capability of the patients were improved from pre-operative to final follow up visit. Conclusions: Long segment transpedicular screw fixation is an effective method of treatment in patients having thoracolumbar spine injury with incomplete neurological deficit.

KEYWORDS

Neurological Deficit, Transpedicular Screw Fixation, Unstable Thoracolumbar Spine Injury

Cite this paper

Karim, S. , Rahman, A. , Sobhan, S. , Akon, M. , Hossain, M. , Ali, A. , Newas, S. , Quddus, M. and Mollick, M. (2020) Outcome of Long Segment Transpedicular Screw Fixation in Unstable Thoracolumbar Spine Injury with Incomplete Neurological Deficit. Journal of Biosciences and Medicines, 8, 166-187. doi: 10.4236/jbm.2020.83015.
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