A retrospective study of neurological recovery following posterior stabilization for spine instability in tertiary care hospital, Chengalpattu district
Keywords:Spinal instability, Neurological recovery, Denis pain scale, Frankel grade
Background: Spinal instability is defined as the loss of the ability of the spine under physiological loads to maintain relationships between vertebrae in such a way that the spinal cord or nerve roots are not damaged or irritated, and deformity or pain does not develop. The objective was to study the neurological recovery following posterior stabilization for lumbar spine instability.
Methods: This retrospective study was conducted in the Department of Orthopaedics, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Chengalpattu district, Tamil Nadu, India. (KIMS & RC). Study duration was from January 2020 to February 2020 (2 months). Patients admitted with spinal instability with neurological deficit, treated with instrumentation and fusion will be study participants were 30 patients.
Results: In our study, Denis pain scale showed that 40% of patients had minimal pain, 40% of patient had moderate pain and 20% had moderate to severe pain with significant changes in daily activities, the Denis work assessment scale showed that 33.33% of patients had unable to return to the previous job but can able to work full time with job modification.
Conclusions: The most important factor responsible for prognosis and neurological recovery is the neurological status at the time of injury. Surgical decompression and stabilization with fusion improves the neurological recovery especially in incomplete cord lesions.
Aebi M, Etter C, Kehl T. Stabilization of the lower thoracic and lumbar spine the internal spine skeletal fixation system. Indication, technique, and first results of treatment. Spine. 1987;12:544-51.
Broom MJ, Jacobs RR. Current Status of Internal Fixation of Thoracolumbar Fractures. J Orthop Trauma. 1989;3:148.
Butt MF, Farooq M, Mir B, Dhar AS, Hussain A, Mumtaz M. Management of unstable thoracolumbar spinal injuries by short-segment spinal fixation. Int Orthop. 2007;31:259-64. J Bone Joint Surg (Am). 1983;65:461-73.
Danisa OA, Shaffrey CI, Jane JA, Whitehill R, Wang GJ, Szabo TA, et al. Surgical approaches for the correction of unstable thoracolumbar burst fractures: a retrospective analysis of treatment outcomes. J Neurosurg. 1995;83:977-83.
Denis F. Spinal Instability As Defined by the Three-Column Spine Concept in Acute Spinal Trauma. Clin Orthop. 1984;189:65-76.
Denis F. The three columns of the spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine. 1983;8:817-31.
Dick W, Kluger P, Magerl F, Woersdorfer O, Zach G. A new device for internal fixation of thoracolumbar and lumbar spine fractures: the fixator internet. Paraplegia. 1985;23:225-32.
Gertzbein S. Scoliosis Research Society. Multicenter spine fracture study. Spine. 1992;17:528:40.
Gurwitz GS, Dawson JM, McNamara MJ, Federspiel CF, Spengler DM. Biomechanical analysis of three surgical approaches for lumbar burst fractures using short-segment instrumentation. Spine. 1993;18:977-82.
Holdsworth F. Fractures, Dislocations, and Fracture-Dislocations of the Spine. J Bone Joint Surg Am. 1970;52:1534-51.
Holdsworth FW. Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg (Br). 1963;45:6-20.
Jacobs RR, Casey MP. Surgical management of thoracolumbar spinal injuries. Clin Orthop Relat Res. 1984;189:22-35.
Jeffrey WP, Joel RL, Eldin EK, Robert WG. Successful Short-Segment Instrumentation and Fusion for Thoracolumbar Spine Fractures A Consecutive 4 1/2-Year Series. Spine. 2000;25:1157-69.
Kaneda K, Abumi K, Fujiya M. Burst Fractures With Neurologic Deficits of the Thoracolumbar-Lumbar Spine. Results of Anterior Decompression and Stabilization With Anterior Instrumentation. Spine. 1984;9:788-95.
Kelly RP, Whitesides TE. Treatment of lumbodorsal fracture-dislocations. Ann Surg. 1968;167:705.
Knoeller SM, Seifred C: Historical perspective: a history of spinal surgery. Spine. 2000;25:2838-43.
Langrana NA, Harten RD RD, Lin DC, Reiter MF, Lee CK. Acute thoracolumbar burst fractures: a new view of loading mechanisms. Spine. 2002;27:498-508.
Laser JA, Estes WJ. Distal short segment fixation of thoracolumbar and lumbar injuries. Iowa Orthop J. 1998;18:87-90.
T, Karaikovic E, Gaines RW. The load sharing classification of spine fractures. Spine. 1994;19:1741-4.
McHenry LC Jr. Garrison's History of Neurology. Springfield, IL: CC Thomas. 1969: 3-24.