Vol. 10, Issue 4 (2024)

Introduction and Aim: Spine fractures are common in today’s world due to high frequency of motor vehicle accidents and work place injuries. These are a major cause of disability in the adult population. The mortality rate following spinal injuries is 7%. Thoracolumbar junction is the most mobile segment which makes it more prone to injury. Management of these injuries are still under debate. Internal fixation provides early mobilization of the patients and protects the neurological structures. Conventional short segment stabilization is associated with high failure rates especially if anterior column injury is severe. In these cases, short segment stabilization with intermediate screws provides better stability and avoids future anterior surgery. In this study we aim to study the outcome of Traumatic Dorsolumbar Fractures treated with Posterior stabilization by pedicel screw fixation.
Materials and Methods: This is a prospective interventional study done at the Department of Orthopaedics Government Medical College at Jammu between August 2021 and August 2022. Twenty patients with dorso-lumbar spine fractures who were willing to take part in the study were included in this study. All the patients were treated by posterior stabilization with poly-axial pedicle screw fixation. All the patients were followed up for a minimum of 12 months. All 25 patients were available for follow-up till 12 months.
Observation and Results: The mean age of the study group was 38.4 years, males being most common (68%). The most common mode of injury was fall from height (68%) followed by road-traffic accidents (32%). The most frequently fractured vertebra was D11 followed by L1 in our study. The most common type of fracture was type A (80%). The preoperative regional kyphotic angle was 16.56°which improved to 10.44°at 1-year follow-up with a mean correction of 6.12°. Our study also shows improvement of vertebral height from a preoperative value of 13.5 mm to a value of 20.4 mm during the last follow up, i.e., an improvement from 45% to 68% of vertebral height. In our series, out of 25 pateints, 16(55%) were having denis pain scale of P1,06(30%) were having scale of P2, 2 (10%) patients were having scale of P3and 1(5%) patient was having a scale of P4 In our series, out of 25 patients, 12 were having denis work scale W1,11 were having work scale of W2, 01 patient was having W3 & 1 patient was having work scale W4. In our study,21 patients had no complications. 1(5%) patient had rod displacement,1(5%) patient had screw misplacement and 1(5%) patient had dural puncture and 1(5%) patient had superficial wound infection.
Conclusion: From our study we conclude that posterior stabilization with pedicle screw and rod system is an excellent option for dorso-lumbar spine fractures. It resulted in good improvement in post-operative regional kyphotic angle and anterior vertbral height. Also, the post-operative neurological status has improved in a significant number of patients and the over-all functional outcome of patients according to the Denis pain and Deniswork scale has shown improvement.