Evaluation the results of surgical management of traumatic paraplegia in traumatic thoracolumbar fractures

Authors

  • Subarna Misra Department of Orthopedics,ICARE Institute of Medical Sciences and Research, Banbishnupur, Haldia, West Bengal
  • Sukanta Sen Department of Pharmacology, ICARE Institute of Medical Sciences and Research, Banbishnupur, Haldia, West Bengal
  • Sujoy Das Department of Orthopedics,ICARE Institute of Medical Sciences and Research, Banbishnupur, Haldia, West Bengal
  • Abhishek Chatterjee Department of Orthopedics, ICARE Institute of Medical Sciences and Research, Banbishnupur, Haldia, West Bengal
  • Aniruddha Sengupta Department of Orthopedics, Midnapore Medical College and Hospital, Vidyasagar Road, Paschim Medinipur, West Bengal
  • Suvasis Saha Department of Orthopedics, Calcutta National Medical College, 32, Gorachand Road, Kolkata, West Bengal

DOI:

https://doi.org/10.18203/2320-6012.ijrms20161797

Keywords:

Spinal cord injury, Traumatic paraplegia, Dorsolumbar spine, Decompression, Posterior fixation, Neurological deficit

Abstract

Background: Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Aim of this study was to evaluate the results of surgical management of traumatic paraplegia, complete or incomplete as classified by Frankel scoring.

Methods: A prospective study was conducted in patients attending outdoor and emergency department of Orthopedics of a tertiary care teaching institute in Kolkata, West Bengal with traumatic paraplegia involving the dorsolumbar spine. The important objectives are the time for recovery of various functions like sensory, motor and bowel and bladder function, comparison between early and late decompression, results of posterolateral fusion and time taken for solid bony fusion after operation. Total 46 cases were selected within a minimum of 6-month post-operative follow-up of which 4 cases lost in follow-up. Data collected from patient records included age, sex, time from injury to hospitalization, initial neurological status as per Frankel Score, MRI findings, surgery performed, postoperative course and neurological status at the time of discharge and latest follow up. Patients lost to follow up were not studied for outcome analysis.

Results: When decompression done within 1st week in incomplete paraplegia, 80% of the patients showed return of grade 3 power. In complete paraplegia cases, 11% of the patients had return of power up to grade 3 when decompression done within 1 week, where no cases showed return of grade 3 power when decompression done after 2nd or 3rd week.

Conclusions: After recovery from spinal shock, the earlier the surgical compression done, the better the neurological and bowel/bladder function recovery both in complete and incomplete paraplegic cases. Reduction is better and easy and less time consuming in early decompression than in late. Motor recovery can continue for over 6 months after decompression.

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Published

2017-01-02

How to Cite

Misra, S., Sen, S., Das, S., Chatterjee, A., Sengupta, A., & Saha, S. (2017). Evaluation the results of surgical management of traumatic paraplegia in traumatic thoracolumbar fractures. International Journal of Research in Medical Sciences, 4(6), 2262–2270. https://doi.org/10.18203/2320-6012.ijrms20161797

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Original Research Articles