Functional outcome of traumatic paraplegia and paraparesis patients treated with pedicle screw stabilization with decompression

Authors

  • Arif P. K. Senior Resident, Government Medical College, Kottayam, Kerala, India
  • Tigy Thomas Jacob Department of Orthopedics, Government Medical College, Kottayam, Kerala, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20210631

Keywords:

Decompression, Frankel score, Moss Miami pedicle screw stabilization, Neurological deficit

Abstract

Background: In this study, unstable thoracolumbar spine fractures with neurological deficit fixed with Moss Miami pedicle screw and decompression were followed up for neurological improvement (sensory and motor functions). Patients were admitted in the department of Orthopaedics, Government medical college, Kottayam from November 2016 to October 2017.

Methods: In this observational study, 96 patients (aged 17 to 60 years) are followed up. The preoperative neurological status and post-operative recovery are follow-up at 1, 3 and 6 months and graded by Frankel’s grading. Change from Frankel’s grade A OR B to Frankel grade C, D OR E was said to be improved neurologically.

Results: 87.3% males and 12.7% females with 58.3% patients having fall from height sustained wedge compression fractures (49.1%), burst fractures (46.8%) and fracture dislocations (4.1%). vertebra fractured were L1-31.4%, T12-22.9% and L2-19.7%. Complete paralysis was 44.8% and 55.2% incomplete. At 6 months 75% patients showed improvement and 25% patients showed nil. 95.5% patients (18-30 years) showed improvement and only 50% (51-60 years). Incomplete neurological deficit showed significant improvement (100%) compared to patients with complete paralysis (44.2%). Preoperative Frankel score has significant relationship with final neurological (44% of patients with Frankel A and 100% with Frankel D.

Conclusions: Moss Miami pedicle screw stabilization with decompression is an effective surgical technique in maintaining stability of spine in traumatic paraplegia and paraparesis patients and there is significant improvement in neurological status.

Author Biography

Tigy Thomas Jacob, Department of Orthopedics, Government Medical College, Kottayam, Kerala, India

Additional Professor

Department in Orthopaedics

Govt. Medical College, Kottayam.

Kerala, India.

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Published

2021-02-23

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Original Research Articles