Clinical and Functional Outcomes of Thoracolumbar Spine Fractures Managed with Short Segment Pedicle Screw Fixation in a Tertiary Care Hospital

Open Access

Abstract

Background: Thoracolumbar spine fractures are one of the most common and potentially devastating spinal injuries in the world. Short-segment pedicle screw fixation (SSPF) has become the surgical technique of choice in the treatment of unstable thoracolumbar fractures. The study aimed to assess clinical, functional, and radiological outcomes of thoracolumbar spine fractures treated with SSPF in a tertiary care hospital in Bangladesh. Methods & Materials: This prospective observational study was carried out at National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh from July, 2024 to December, 2024, recruiting 40 patients with thoracolumbar fractures (T11-L3) who underwent SSPF during an 18-month study period. The Visual Analogue Scale (VAS) of back pain and the Oswestry Disability Index (ODI) were used to measure functional outcomes preoperatively and at 3 and 6 months postoperatively. The ASIA Impairment Scale was used to assess neurological status. Prospective documentation of complications was done. Data were entered and analyzed on SPSS version 26. Results: The mean age was 36.4 years, with a high percentage of males (72.5%). The most common injury mechanisms were road traffic accidents (45%) and falls from height (40%). The most frequently fractured level was L1 (40%), and burst fractures were 60% of the cases. Significant improvements were recorded in VAS score (7.6 to 2.1) and ODI (61.8 to 23.4) at 6 months (p<0.001). Neurological improvement by at least one ASIA grade was observed in 14 patients, 35.0%, at 6 months. The Kyphotic angle decreased from 19.6 to 8.4 (p<0.001). There was no neurological worsening or death. Conclusion: SSPF is a safe and effective surgical procedure for treating unstable thoracolumbar fractures, offering significant functional recovery, neurological improvement, and reliable radiological correction with an acceptable complication profile.