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

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.

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.

Neurological Deficit, Transpedicular Screw Fixation, Unstable Thoracolumbar Spine Injury

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.