MANAGEMENT OF THORACOLUMBAR SPINE INJURIES AT A TERTIARY CARE HOSPITAL
AbstractBackground: The purpose of descriptive case series study was to see the conservative andsurgical outcome in respect of neurological improvement, sphincter functions and earlyambulation in cases of traumatic thoracolumbar injuries in a tertiary care hospital. Methods:This was a hospital based prospective study comprised of 50 thoracolumbar injury casesregistered during the period of 1 year from September 2005 to September 2006. All cases wereevaluated for their clinical features. During initial phase, level and degree of neurological injurywas assessed using Frankle grades. Operative and postoperative record with x-rays and MRIwere maintained. The follow-up ranged from 6 to 12 months with clinical and radiologicalassessment. Results: A total of 50 cases were registered, 43 (86%) were males and 7 (14%)were females. Fall was the most common cause of injury (92%). The most common levelinvolved was L1 (46%). The 2nd common site of injury was T12 (12%). The treatment given wasconservative in 42.55%, and surgery was performed on 57.44%. Three (6.38%) patients wereleft against medical advice. Conclusion: Thoracolumbar injuries occur in young population andcreates socio-economic burden to the society. Patients with partial neurological deficit benefitfrom surgery.Keywords: Spinal injury, Thoracolumbar, Fall, Road Traffic Accident
Spink MS, Lewis GL. Albucasis on Surgery and Instruments.
California: Berkeley University Press; 1973.p. 812–19.
Dickman CA, Fessler RG, Macmillan M, Haid RW.
Transpedicular screw rod fixation of the lumbar spine. Operative
technique and outcome in 104 cases. J. Neurosurg 1992;77: 860–
Esses SI, Bostford DJ, Wright R, Bednar D, Bily S. operative
treatment of spinal fractures with AO internal fixater. Spine
Rimoldi RL, Huss SS, Zigler JE, Capen DA. The effect of
surgical intervention on rehabilitation time in patients with
thoracolumbar and lumbar spinal cord injuries. Spine
Hammell KW. Spinal injury. Etiology, incidence and
impairments, In: Spinal cord injury rehabilitation. Champer and
Ernest M, Found Jr. Fractures of the spine In: Orthopedics;
Essentials of diagnosis and treatment. Clark B. (editor). New
York: Churchill Livingstone;1994.p.199–214.
Bedbrook GM. Spinal injuries with tetraplegia and paraplegia. J
Bone Joint Surg 1980;67A:360–9.
Dennis F. The three column spine and its significance in the
classification of acute thoracolumbar spinal injuries. Spine
Chesnut RM, Marshall LF. Early assessment, transport and
management of patient with posttraumatic spinal instability. In:
Cooper PR. (editor). Management of post traumatic spinal
instability. Neurosurgical topics. Park Ridge IL: American
Association of Neurological surgeons; 1990. p. 1–18.
Braken M, Shepard MJ, Holford TR. Administration of
methylprednisolone for 24 or 48 hours or tirilazad mesylate for
hours in the treatment of acute spinal cord injury. JAMA
Shah AA, Memon IA. Antero-lateral decompression for
traumatic spinal cord compression. J Pak Med Assoc
Sarwar MO. Hussain A, Khan AN. Surgical Management of
unstable thoracolumbar injuries. Proceed Sheikh Zaid PGMI
Hitchon PW, Torner JC, Hadded SS, Follett KA, Thoracic and
lumbar fractures. Management analysis. In: Hitchon, Traynelis,
Rengachary, Techniques in spinal fusion and stabilization. New
York: Thieme Medical Publishers;1995.p.338–44.
.MC Cormack B, Mac Millan M, Fessler RG. Management of
thoracic, lumbar and sacral injuries. In: Tindall Gt, Cooper PR,
Barrow DL. (Editors). Practice of Neurosurgery. Vol II.
Baltimore: William and Wilkins; 1996.p.1721–8.
Gunby P. New focus on spinal cord injury, medical news, JAMA
Gertzben SD, Court Brown CM, Mark P. The neurologic
outcome following surgery for spinal fractures. Spine
McLain RF, Sparling E, Benson DR. Early failure of shortsegment pedicle instrumentation for thoracolumbar fractures. A
preliminary report. J Bone Joint Surg 1993;75:162–7.
Lewandrowski K, McLain RF, Thoracolumbar Fractures:
Evaluation, Classification,and Treatment. In Frymoyer JW,
Wiesel SW. (editors). The adult and pediatric spine. 3rd
edition, Vol. 2, Philadelphia: Lippincot Williams & Wilkins;
Riebel GD, Yoo JU, Fredrickson BE, Yuan HA. Review of
Harrington rod treatment of spinal trauma. Spine