Spinal Canal Remodeling in Operated Cases of Thoracolumbar Fractures.

ABSTRACT

Introduction: Among trauma patients 6% have spinal column injury, half of which have spinal cord or nerve root injury. Road traffic accidents being the most common cause. Burst fractures account for more than half of the thoracolumbar fractures which are treated by various modalities of fixation and decompression. Aim: The aim of this study is to compare direct and indirect surgical decompression of the spinal canal in patients with thoracolumbar fractures with neurodeficit and to compare spinal canal remodeling. Materials and Methods: A total of 30 patients with thoracolumbar fractures were divided into two groups, Group 1 with direct and Group 2 with indirect decompression. Canal diameters were recorded before and after surgery and at follow-up. The patients were followed up at 3, 6, and 12 months. Both groups will be compared using Student’s paired t-test and Chi-square test. Results: Both groups were comparable in terms of age, sex, mode if injury, site of injury, and pre-operative canal diameters. After surgery, mean diameter for G1 1.2 cm (standard deviation [SD] ± 0.03) and G2 1.15 cm (SD ± 0.04) canal diameters improved in both groups with P < 0.05, however among both groups, the P < 0.05 showing that better canal clearance was achieved in G1 than in G2. Diameter at 1 year for G1 1.37 cm (SD ± 0.048) and G1 1.37 cm (SD ± 0.029), though the improvement in canal diameters from post-operative period to 1 year is significant in each group (P value in both groups <0.001), and among groups, the difference is not significant with P > 0.05. Conclusion: The neurological damage in thoracolumbar burst fractures occurs at the precise moment of injury. Furthermore, there is spontaneous remodeling potential of the spinal canal.