Dorsolumbar spine fractures are one of the most common cause of traumatic paraplegia and paraparesis with or without bladder and bowel involvement in younger individual. This is one of the controversial areas in modern spine surgery and continues to evolve.
Aim: To analyse the radiological and functional outcome in patients with dorsolumbar burst fractures treated with dorsal instrumentation and transpedicular bone grafting.
Material and Methods: 21 patients (20males and 1 female) admitted in govt rajaji hospital, Madurai medical college with dorsolumbar burst fracture with TLICS score more than 5 included in this study. All the patients were treated with dorsal instrumentation and transpedicular bone grafting and posterior decompression if neurological deficit present. Patients were followed up and assessed for functional outcome with denis pain pain scale and denis work scale, neurological outcome by ASIA scale and radiological outcome by anterior wedge angle, anterior height, posterior height, kyphotic angle.
Results: 21 patients (20 males, 1 female) with history of fall from height (86%) and RTA (14%)with TLICS of more than 5 (score 5:16patients, score 6:1patient, score 7:2 patients, score 8:2 patients) were included in the study. 57.1% of patients were 20-40years old. On follow up 2 patients improved from ASIA B to ASIA C and 1patient from ASIA C to ASIA D. among 21 cases, mean Anterior Wedge Angle (AWA) was 18.04° pre operatively which was corrected to 9.42° and on follow up, mean AWA was 10.14°. Mean Anterior Height (AH) was 64.09% pre operatively which was improved to 83.66% and on follow up, mean Anterior Height was 78.57%. Mean Posterior Height (PH) was 83.90% pre operatively which was improved to 93.80% and on follow up, mean Posterior Height was 92.33%. Mean Kyphotic angle was 8.85° pre operatively which was corrected to 5.42° and on follow up, mean Kyphotic angle was 6.38°.
Conclusion: dorsolumbar burst fractures treated with dorsal instrumentation and transpedicular bone grafting facilitate early mobilisation of patients and achieving stable, pain free spinal column and preventing the late vertebral collapse, loss of kyphosis correction and instrumentation failure.