A One Year Study of Efficacy of Pedicular Screw and Rod Fixation System in Stabilisation Of Thoracic & Lumbar Lesions of The Spine, At KLE Hospital & MRC Belgaum

Abstract

OBJECTIVES : ABSTRACT The spinal disorders are one of the leading and grave problems in orthopaedic practice, more so in modern era where the individual are more at risks due to their day-to-day activities. There are number of instrumentation available for fixation of thoracic and lumbar lesions. There are reported results of pedicular screw and rod fixation in thoracic and lumbar lesions of spine and its clinical outcome. METHOD : This longitudinal prospective study of pedicular screw and rod fixation in thoracic and lumbar fractures was done in 21 cases during the period of September 2006 to September 2007 in KLES Dr. Prabhakar Kore Hospital and MRC, Belgaum. All patients were treated surgically by Pedicular screw and rod instrumentation. The Denis pain and work scale was used post operatively to assess the clinical outcome. Initial preoperative clinical and radiological assessment was done. ASIA ( American Spinal injury association) grading, saggital angle, saggital index, slip percentage and slip angle were used pre and post operatively to assess the outcome. Prophylatic antibiotics were given for 5 days. Follow up of patients was done both clinically and radiological at 1 st , 2 nd , 3 rd IX , 4 th , 5 th and 6 th month and assess for any complication. At end of 6 months of follow up Denis pain and work scale was used to assess the clinical outcome. RESULTS AND CONCLUSION : Posterior stabilization by pedicular screw and rod is an effective method of achieving spinal stabilization in thoracic and lumbar lesions. It is an effective method of restoring spinal angulation and maintaining the spinal correlation post operatively and at follow up. The Pedicular screw fixation is associated with less number of complications. It helps fairly in improving the neurological status and the clinical outcome has been satisfactory in terms of Denis work and pain score. The disadvantage of pedicular screw fixation is that it has steep learning curve and high technical expertise is required to minimize complications.