THORACOLUMBAR JUNCTION INJURIES AND THEIR MANAGEMENT WITH PEDICLE SCREWS
Abstract
Background: To evaluate the use of pedicle screw fixation in earthquake injured thoracolumbarspine. Methods: Nineteen patients with posttraumatic instability of lower thoracic or upper lumbar
spine were included in the study. White and Panjabi criteriawas used to assess spinal instability. All
patients underwent open reduction and internal fixation by posterior approach. Pedicles were
localized using detailed anatomical landmarks and intraoperative imaging. . Local bone was used as
bone graft. The neurological status of the patients and any other complications were noted up to one
year. Results: There were 19 patients with unstable thoracolumbar junction injuries who were
managed with pedicle screws and rods. Females were more affected (F:M ratio was 8.5:1). Wedge
compression was the commonest. None of the patients deteriorated after surgery. There were 20
Frankel improvements in 18 patients (1.11 Frankel on average) with neurological deficit whereas 1
patient in Frankel E remained in the same grade on subsequent follow-ups. There was one patient
with wound infection and one patient developed DVT. None of the patients developed bedsores.
Conclusion: Pedicle screw fixation is a useful choice for thoracolumbar junction injuries for
achieving reduction and stability in both anterior and posterior column injuries, without affecting
extra motion segments.
Keywords: Pedicle screws, thoracolumbar junction injuries
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