title: Outcome of pedicle screw fixation and monosegmental fusion in patients with fresh thoracolumbar fractures.
abstract: METHODS
  Prospective clinical study.
  
  
  OBJECTIVE
  The present prospective study aims to evaluate the clinical, radiological, and functional and quality of life outcomes in patients with fresh thoracolumbar fractures managed by posterior instrumentation of the spine, using pedicle screw fixation and monosegmental fusion.
  
  
  BACKGROUND
  The goals of treatment in thoracolumbar fractures are restoring vertebral column stability and obtaining spinal canal decompression, leading to early mobilization of the patient.
  
  
  METHODS
  Sixty-six patients (46 males and 20 females) of thoracolumbar fractures with neurological deficit were stabilized with pedicle screw fixation and monosegmental fusion. Clinical, radiological and functional outcomes were evaluated.
  
  
  RESULTS
  The mean preoperative values of Sagittal index, and compression percentage of the height of the fractured vertebra were 22.75° and 46.73, respectively, improved (statistically significant) to 12.39°, and 24.91, postoperatively. The loss of correction of these values at one year follow-up was not statistically significant. The mean preoperative canal compromise (%) improved from 65.22±17.61 to 10.06±5.31 at one year follow-up. There was a mean improvement in the grade of 1.03 in neurological status from the preoperative to final follow-up at one year. Average Denis work scale index was 4.1. Average Denis pain scale index was 2.5. Average WHOQOL-BREF showed reduced quality of life in these patients. Patients of early surgery group (operated within 7 days of injury) had a greater mean improvement of neurological grade, radiological and functional outcomes than those in the late surgery group, but it was not statistically significant.
  
  
  CONCLUSIONS
  Posterior surgical instrumentation using pedicle screws with posterolateral fusion is safe, reliable and effective method in the management of fresh thoracolumbar fractures. Fusion helps to decrease the postoperative correction loss of radiological parameters. There is no correlation between radiographic corrections achieved for deformities and functional outcome and quality of life post spinal cord injury.
authors: Department of Orthopaedic Surgery, Paraplegia and Rehabilitation, PGIMS, Rohtak, India.
authors: Roop
authors: R
authors: Singh
authors: Department of Orthopaedic Surgery, Paraplegia and Rehabilitation, PGIMS, Rohtak, India.
authors: Rajesh Kumar
authors: RK
authors: Rohilla
authors: Department of Orthopaedic Surgery, Paraplegia and Rehabilitation, PGIMS, Rohtak, India.
authors: Kulbhushan
authors: K
authors: Kamboj
authors: Department of Orthopaedic Surgery, Paraplegia and Rehabilitation, PGIMS, Rohtak, India.
authors: Narender Kumar
authors: NK
authors: Magu
authors: Department of Anaesthesiology and Critical Care, PGIMS, Rohtak, India.
authors: Kiranpreet
authors: K
authors: Kaur
keywords: Fractures; Functional outcome; Neurological involvement; Pedicle screws; Radiological outcome; Thoracolumbar