Results of Spinal Fixation in Thoracolumbar Spine fractures with Spinal Cord Injury using the ASIA Impairement Scale
Journal of Medical Science And clinical Research
Spinal fixation provides stability to the vertebral column but the treatment of unstable fractures of thoracolumbar spine has long been controversial. Probably the best way is to understand that Vertebral column disruption with neurodeficit (signifying spinal cord injury) means there is spinal instability as it denotes a failure of the stabilizing role of the vertebral column. Neurological status in complete and incomplete lesions was compared as per ASIA Impairement Scale after 6 months of
... ter 6 months of surgery. An effort was done to find the effect of spinal fixation in different types of vertebral and cord lesions in our scenario. On the analysis of our results we found out that most of the patients presented after 24 hours of injury and that there were a larger percentage of complete spinal cord lesions than incomplete spinal cord lesions. The postfixation neurorecovery results by a comparison of the ASIA Impairement Scale preoperative and six months postoperative showed that there was neither sensory nor motor recovery in any of the patients of complete lesion whereas there was variable amount of motor and sensory recovery in incomplete lesions. We had our share of complications too. There were three cases of superficial infections, (which resolved with medication and dressings uneventfully), two of peroperative dural tear (controlled uneventfully) and two cases of implant breakage. Spinal fixation, fusion and decompression may help in early neurological recovery in incomplete lesion. Even a small amount of recovery in any lesion is very useful to the patient. Even in cases where there is no neurorecovery, stabilization of the spine by spinal fixation helps in early mobilization in both incomplete as well as complete lesions which is necessary for physical and occupational rehabilitation. Proper patient selection, meticulous surgery and a knowledge of prognosis is important and goes a long way in patient as well as doctor satisfaction. A review of the available relevant literature was also done.