Thoracolumber Vertebral Fractures; Outcome of Short Segment Transpedicular Fixation

Abstract

For spinal injuries, thoracolumbar junction is common site in our population. Surgical management of unstable fractures and fracture dislocations of thoracolumbar spine is still controversial. This study was conducted to document efficacy of short segment fixation of thoracolumbar verterbral fractures. Objectives: To determine the outcome of short segment transpedicular fixation of thoracolumbar fractures. Study design: Descriptive cross-sectional study. Sampling technique: Non-probability purposive sampling. Material and Methods: A total of 103 study cases with thoracolumbar vertebral fractures were taken in this descriptive case series study which was conducted at department of Neurosurgery, Nishtar Hospital Multan from February 2014 to June 2015. Informed verbal consent was taken from each patient before participation in this study ensuring them confidentiality of the information and explaining them objectives and procedure of our study. Once registered, detailed history and clinical examination was done by a Neurosurgeon, investigations like X-ray dorsolumbar spine, CT scan and Magnetic resonance imaging (MRI) dorsolumbar spine were also done. Short segment transpedicular fixation was done and outcome of surgical management was assessed in terms of improvement in power, hardware failure and infection by consultant neurosurgeon. All the study cases were called for follow up visits after every month till 6 months to record final outcome of management. All the information were recorded in the study proforma. Data were entered and analyzed by SPSS version 22. Results: Out of these 103 study cases, 66 (64.1 %) were male patients and 37 (35.9 %) were female patients and male to female ratio was 1.85:1. Mean age of our study cases 33.92 ± 9.72 years ranging from 20 years to 54 years. Mean ages of male patients was 36.68 ± 10.37 years while in female patients it was 29.00 ± 5.89 years (p=0.000).Post-surgical management improvement in power was seen in 55 (53.4%) of our study cases, hardware failure in 11 (10.7%) and infection was observed in 20 (19.4%). Conclusion: According to our study short segment transpedicular fixation is safe & effective procedure providing efficient spinal stability. Short segment fixation is associated with minimum blood loss and trauma and leads to early mobilization of the patient and ease in physiotherapy. Transpedicular screw fixation is a useful choice for achieving better neurological recovery and good pain control in post-traumatic thoracolumbar fractures.

EFFICACY OF ORAL ZINC SULPHATE VERSUS TOPICAL APPLICATION OF SALICYLIC ACID (16.7%) & LACTIC ACID (16.7%) COMBINATION IN THE TREATMENT OF PLANTAR WARTS

“…Oral zinc sulphate is also an effective therapy in the treatment of warts. Zinc has an important effect on the immune system and it has been used as an immunomodulator to treat a variety of skin disorders [9][10][11][12] . Efficacy with oral Zinc sulphate is reported to be 82 % while 62% topical application of salicylic acid (16.7%) & lactic acid (16.7%) combination 6 .…”