A Comparative Study of Management of Thoracolumbar Spine Injuries with Neurological Deficit by Steffee Plating and Conservative Method.

ABSTRACT

In a prospective study conducted in the Postgraduate Department of Orthopaedics Govt. Medical College, Jammu, over a period of 2 years. Forty cases, both male and female in the age group of 20 to 50 years with thoracolumbar spinal injury between D11 and L2 vertebra with neurological deficit were included . Out of these forty cases, 20 cases were managed by posterior decompression and stabilization with Steffee plating and 20 cases of similar injuries were managed conservatively and comparison of the two groups was made. The results were analyzed according to neurological improvement as per Frankel's grading, the complications and the duration of hospital stay in both the groups. In operative group; 50% of the patients showed some degree of recovery with 30% of the patients showed full recovery. The mean postoperative correction of kyphosis was 12.5% and the average hospital stay was 23.7days. 15% of the patients in operated group developed complications. In the conservative group; 30% of the total patients showed neurological recovery with 20 % patients showed significant recovery (Grade D). There were various complications in 65% patients and the average hospital stay was recorded as 40.5 days. General complications were more in conservative group. In view of increased incidence of neurological recovery, decreased incidence of complications, decrease in hospital stay and ease of nursing care in case of operated group, we recommend posterior spinal fixation with Steffee plate system in patients with unstable dorsolumbar spinal fractures especially with incomplete neurological deficit to be adopted in oprative practise.