THORACOLUMBAR JUNCTION INJURIES AND THEIR MANAGEMENT WITH PEDICLE SCREWS
AbstractBackground: To evaluate the use of pedicle screw fixation in earthquake injured thoracolumbarspine. Methods: Nineteen patients with posttraumatic instability of lower thoracic or upper lumbarspine were included in the study. White and Panjabi criteriawas used to assess spinal instability. Allpatients underwent open reduction and internal fixation by posterior approach. Pedicles werelocalized using detailed anatomical landmarks and intraoperative imaging. . Local bone was used asbone graft. The neurological status of the patients and any other complications were noted up to oneyear. Results: There were 19 patients with unstable thoracolumbar junction injuries who weremanaged with pedicle screws and rods. Females were more affected (F:M ratio was 8.5:1). Wedgecompression was the commonest. None of the patients deteriorated after surgery. There were 20Frankel improvements in 18 patients (1.11 Frankel on average) with neurological deficit whereas 1patient in Frankel E remained in the same grade on subsequent follow-ups. There was one patientwith 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 forachieving reduction and stability in both anterior and posterior column injuries, without affectingextra motion segments.Keywords: Pedicle screws, thoracolumbar junction injuries
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