Clinico-Radiological Profile of Thoraco-Lumbar Fractures -An Institutional Experience

Abstract

Introduction: The thoracolumbar fracture constitutes 90% of all traumatic spine fractures, out of which thoracolumbar junction (TLJ) accounts for 50-60% of all thoracolumbar fractures.

Patients and Methods:A retrospective as well as prospective study was conducted in 30 patients from March 2020 to February 2021 in Sher-I-Kashmir institute of Medical Sciences, Srinagar. All patients radiologically diagnosed as thoracolumbar spinal injury were clinically evaluated, classified and treated accordingly. Pre- and post-operative clinical grading of the patients were noted and outcome assessed as good or poor. Results:In the study, 20 patients had a good outcome out of which almost half had wedge angle <25^o& canal compromise <50%, 16 had kyphotic angle <25^oand 7 patients had cord contusion. Among 10 patients who had poor outcome, 6 had wedge angle >25^o, 7 had kyphotic angle >25^o& 7 had a canal compromise >50% and 9 patients had cord contusion on assessment of MRI.

Conclusions:Imaging parameters like wedge angle, canal compromise & cord contusion can be correlated with initial neurological status for better understanding of treatment and the prognosis of the injury. Wedge angle greater than 25^o, canal compromise of more than 50% and an ASIA grade ‘C’ and below, are best treated surgically and carry a poor prognosis. Non operative treatment choices are reserved for patients with good clinical and radiological grading.