Evaluation of correction of kyphotic deformity in dorso-lumbar spinal injuries by posterior stabilization with pedicular screw rod fixation


  • N. Srinivasan Department of Orthopedics, Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, Telangana
  • Y. V. S. Prabhakar Department of Orthopedics, Malla Reddy Institute of Medical Sciences, Suraram, Hyderabad, Telangana




Posterior reduction, Internal fixation, Acute injuries, Spine


Background: Acute injury to dorso-lumbar spine is the second most frequent site after cervical spine in adults. The injury, although not associated with high mortality, causes severe morbidity. The management of the traumatic dorso-lumbar spine injuries has improved considerably in the last few years. The objective of the study was to evaluate correction of kyphotic deformity in dorso-lumbar spinal injuries by posterior stabilization with pedicular screw rod fixation.

Methods: The study includes 52 patients with dorso-lumbar spinal injuries with or without neurological deficit treated between 2006 and 2014. Pre and postoperative kyphosis was measured by Cobb’s method on plain radiographs. Pre and postoperative neurological status was evaluated based on Frankel’s classification. All un-stable dorso-lumbar spine injuries where two or more columns are involved on X-ray and CT scan were included in the present study.

Results: Majority of the patients were in the age group of 20-30 years (38.5%) followed by 31-40 years (30.8%). Males were more than females. The most common mode of injury was road traffic injury in 71.2% of the cases. The most common level of injury was at L1 in 28.8% of the cases followed by at level D12 in 25% of the cases. In all the groups the mean kyphosis angle is reduced significantly. Overall the improvement rate was 94.2% and failure rate was only 5.8%.

Conclusions: In conclusion the posterior reduction and internal fixation is a useful procedure in the treatment of the acute injuries of the dorsolumbar spine. 


Ramani PS, Patkar SV. Classification and principles of management of injuries to the dorso lumbar junction. In: Textbook of Spinal Surgery. Ramani PS, editors. Mumbai. 1996;27: 221-5.

Ramani PS, Singhania BK, Murthy G. Combined Anterior and Posterior Decompression and Short Segment Fixation for Unstable Burst Fractures in the Dorso Lumbar Region. Neurol India. 2002;50:272-8.

Rengachary SS, Sanan A. Thoraco lumbar fractures. In: Textbook of Spinal Surgery. Ramani PS, editors. Mumbai. 1996;26:216-20.

Sasso RC, Cotler HB, Reuben JD. Posterior fixation of thoracic and lumbar spine fractures using DC plates and pedicle screws. Spine 1991;16(3):S134-9.

Stancic MF, Gregorovic E, Nozica E, Penezic L. Anterior Decompression and Fixation versus Posterior Reposition and Semirigid Fixation in the Treatment of Unstable Burst Thoraco-lumbar Fracture: Prospective. Croatian Med J. 2001;42(1):49-53.

Stanèiæ MF, Miæoviæ V, Potoènjak M. Hook-rod with pedicle screw fixation for unstable spinal fracture. Technical note. J Neurosurg. 2000;92(1):117-21.

Knop C, Fabian HF, Bastian L, Blauth M. Late results of thoraco-lumbar fractures after posterior instrumentation and transpedicular bone grafting. Spine. 2001;26(1):88-99.

Nolan P, Finkelstein JA. Evaluation of 11th rib extra-pleural retroperitoneal approach to the thoraco-lumbar junction. Technical note. J Neurosurg. 2000;93(1):168-74.

Gertzbein SD, Crowe PJ, Fazl M, Schwartz M, Rowed D. Canal clearance in burst fractures using the AO internal fixator. Spine. 1992;17:558-60.

Crutcher JP Jr, Anderson PA, King HA, Montesano PX. In-direct spinal canal decompression in patients with thoraco-lumbar burst fractures treated by posterior distraction rods. J Spinal Disord. 1991;4(1):39-48.

Moon MS, Choi WT, Moon YW, Kim YS, Moon JL. Stabilization of fractured thoracic and lumbar spine with Cotrel-Dubousset Instrument. J Spinal Disord. 1991;4:3948.

Baaj AA, Reyes PM, Yaqoobi AS, Uribe JS, Vale FL, Tehodore N. Biomechanical advantage of the index-level pedicle screw in unstable thoracolumbar junction fractures. J Neurosurg Spine. 2011;14:192–7.

Lazaro BCR, Deniz FE, Brasiliense LBC, Reyes PM, Sawa AGU, Theodore N et al. Biomechanics of thoracic short versus long fixation after 3-column injury. J Neurosurg Spine. 2011;14:226–34.

Wessberg P, Wang Y, Irstam L, Nordwall A. The effect of surgery and remodeling on spinal canal measurements after thoracolumbar burst fractures. Eur Spine J. 2001;10:55–63

Li C, Zhou Y, Wang H, Liu J, Xiang L. Treatment of unstable thoracolumbar fractures through short segment pedicle screw fixation techniques using pedicle fixation at the level of the fracture: a finite element analysis. PLoS One. 2014 9(6):e99156.

Deng Z, Zou H, Cai L, Ping A, Wang Y, Ai Q. The Retrospective Analysis of Posterior Short-Segment Pedicle Instrumentation without Fusion for Thoracolumbar Burst Fracture with Neurological Deficit. The Scientific World J. 2014: 457634,

Chang-Hoon J, Han-Dong L, Sang Y, Hyeon J, Nam-Su C. Is it beneficial to remove the pedicle screw instrument after successful posterior fusion of thoraco-lumbar burst fractures. Spine. 2015;40(11):E627-E633.






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