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

Abstract

Fractures of the thoracic and lumbar region constitute a spectrum of injuries ranging from the simple undisplaced fractures to complex fracture dislocations. Anatomically and functionally, the thoracic and lumbar spine can be divided into three regions-thoracic spine (T1-T10), thoracolumbar junction (T10-L2) and the lumbar spine 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 postoperative 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 1 st 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 2 nd or 3 rd 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.

Effectiveness of bone marrow-derived mononuclear stem cells for neurological recovery in participants with spinal cord injury: A randomized controlled trial

“…This study was performed to evaluate the effect of BM-MNSCs, used as an adjuvant, to conventional management[31] of traumatic SCI for neurological recovery. The results show that neurological recovery is better with stem cell augmentation in SCI surgery.…”