Transpedicular Decompression And Spinal Fixation In Thoracolumbar Burst Fractures

Abstract

Objective: To evaluate the results of transpedicular decompression and single stage pedicle screw fixation in burst fractures of thoracolumbar spine. Materials & Methods: This study was carried out at PNS Shifa from Dec 2010 to Jan 2013. All consecutive traumatic burst fractures that underwent surgery were included in the study. Twenty three consecutive patients aged 17 to 57 (mean, 41) years who had burst fractures in the thoracolumbar (n=13) and lumbar (n=10) regions and were surgically treated were included in this study. There were 18 males and 5 females. Fractures were classified according to the AO classification. The extent of spinal canal compromise was assessed by computed tomography, and the neurological status by the modified Frankel grading for traumatic paraplegia. All patients underwent posterior transpedicular decompression and same stage pedicle screw fixation. Outcome was assessed on Frankel grading scale. Results: The extent and level of neurological injury varied. It did not correlate with extent of canal compromise, age and sex of the patient. Neurological injury was greater with T11 and T12 injuries than Lumbar fractures. No worsening of neurological grade was observed after surgery; rather 20 of 23 patients (86.9%) improved to the next higher grade. Screw malposition to the extent warranting readjustment was noted in 2 cases. Hardware failure occurred in 1 case after 6 months, bed sores in 3 cases and deep vein thrombosis in 1 case. Conclusion: Single stage Transpedicular decompression and spinal fixation from a posterior approach gives good results in burst fractures of thoracolumbar spine.