Spinal canal decompression with short segement stabilisation in thoracic and lumbar burst fractures of spine – a retrospective analysis of 38 cases

Objective: We report the efficacy of indirect spinal canal decompression by short segment pedicle screw fixation and distraction in burst fractures of thoracolumbar region of spine.
Methods: Thirty eight patients with mean age of 34.5 years of thoracolumbar burst fractures were operated by short segment pedicle screw fixation and indirect reduction. Patients in which – fracture pattern was not burst type, direct reduction for canal clearance was required, bone graft was used for fusion and more than one spinal level involved were excluded from the study. X ray of spine (antero-posterior and lateral view) were done in all patients, MRI and CT scan were also done. Neurological examination was done by Frankel’s grading system. Patients were followed for the average period of 2.8 years, the change in vertebral height, kyphotic angle and neurological deficit were recorded postoperatively, at 3 months, 6 months and at final follow up.
Results: Twenty six patients (68%) had neurological deficit, till last follow up 23 patients had complete neurological recovery. In our series Denis Type B was the most common burst fracture pattern, seen in 63% of cases. The vertebral height was restored to 81% (60-88%) postoperatively and kyphotic angle improved to -1 degree (-10 to +14 degrees) from 14.1 degrees (0-28 degrees).
Conclusion: The short segment stabilization and indirect reduction of burst fracture provides stabilisation and reduction of retro pulsed fragment. More space for neural tissue is created after decompression, thus better chances of neural recovery.