Management and Outcome of thoracolumbar spine injury cases at a tertiary care hospital

Abstract

Introduction: Historically, thoracolumbar fractures have been treated with recumbency i.e. bed rest for a period of 8-12 weeks. This mode of treatment is accompanied with complications due to recumbency. It is very labor intensive. Cost of therapy in terms of hospital hours used, bed occupancy and care by trained personnel is very high. In a country like ours, where there is acute shortage of hospital facilities and trained manpower, conservative management, more often than not, ends up as benign neglect. Methodology: This present study is a prospective study of posterior instrumentation with pedicle screw fixation and fusion in traumatic unstable thoracolumbar spine. During the period 23 cases of traumatic thoracolumbar spine fractures were treated operatively with posterior decompression, instrumentation and fusion. Of these, 3 cases were lost to follow up. Hence the results of 20 cases were evaluated Results: In our study Type A fractures And type B fractures had incidence of 40% each. Amongst type A, Type A3 predominated. Amongst Type B, Type B2 predominated. Type C fractures accounted for 20% cases. B & C types of fractures were most commonly seen with RTA. These are high energy injuries that result in polytrauma. Complete or near complete paraplegia is common in this group. Conclusion: Management of thoracic and lumbar spine fractures demands more skills in selecting the right patients for surgery and effective preoperative evaluation.