Functional Outcome of Transpedicular Screw Fixation in Burst Fractures of Thoracolumbar Spine

Background: Transpedicular Screw Fixation is one of the modalities used in surgical management of burst fracture of dorsolumbar spine for prevention of instability & for early rehabilitation of the patient. Aim: To determine the efficacy of this modality and present the clinical results of the patients treated with the help of this protocol. Methods: 45 patients (24 females, 21 males) with a mean age of 32 years were operated upon in department of Orthopedic Surgery, Mayo Hospital, Lahore from 2008 to 2011. 41 patients completed the 2 year follow-up. Burst fracture of dorso-lumbar vertebra was stabilized with posterior instrumentation by transpedicular screws in the healthy vertebra above and below. Posterior decompression was done in cases where canal encroachment was present or neurological deficit was there. Oswestery Disability Index (ODI) was calculated for individual patient after 24 months. Results: Out of 41 patients included in the study, 8 patients had fracture of Dorsal spine, 20 had fracture in dorsolumbar junction and 13 in lumbar area. All the patients were managed surgically with transpedicular screw fixation. After 2 years of follow up according to Oswestry Disability index 34%, 63%, 2.4% had minimal, moderate and severe disability respectively. Conclusion: Transpedicular Screw Fixation is an efficient mode of treatment in burst fracture of lumbar spine in long terms of prevention of disability and in improvement in the neurological deficit caused by instability of the affected vertebra.