Abstract

Objectives: To analyse the radiological and functional outcome in patients with dorsolumbar burst fractures treated with short dorsal instrumentation and facetal fusion.

Material and Methods:51 patients (40 males and 11 female) admitted in Hayatabad medical complex hospital and DHQ hospital Timergara, with dorsolumbar burst fracture. All the patients were treated with transpedicular screw fixation plus facet involve were fused. Posterior decompression performed if neurological deficit present. Patients were followed up and assessed for functional outcome with denis pain pain scale and denis work scale, neurological outcome by ASIA scale and radiological outcome by anterior wedge angle, anterior height, posterior height, kyphotic angle.

Results: 51 patients (40 males, 11 female) with history of fall from height (89%) and RTA (11%)with (unstable burst fractures). 58.1% of patients were 20-40 years old. On follow up 8 patients improved from ASIA B to ASIA C and 4 patients from ASIA C to ASIA D. among 51 cases, mean Anterior Wedge Angle (AWA) was 20.04° preoperatively which was corrected to 8.52° and on follow up, mean AWA was 9.74°. Mean Anterior Height (AH) was 66.19% preoperatively which was improved to 86.56% and on follow up, mean Anterior Height was 80.77%. Mean Posterior Height (PH) was 85.90% preoperatively which was improved to 94.80% and on follow up, mean Posterior Height was 92.83%. Mean Kyphotic angle was 9.25° preoperatively which was corrected to 6.12° and on follow up, mean Kyphotic angle was 5.98°.

Conclusion: Burst fractures treated with dorsal instrumentation and transpedicular bone grafting facilitate early mobilisation of patients and achieving stable, pain free spinal column and preventing the late vertebral collapse.

Keywords:Burst fractures; Transpedicular screw fixation; Thoracolumbar fracture