Management of Thoracolumbar Spinal Fracture at Tertiary Care Hospitals: A Retrospective Study

Abstract

Objective:  This study aimed to evaluate the fracture types, neurological deficits via the ASIA grading system, and to analyze fracture management strategies, post-fracture and surgical complications, in patients with thoracolumbar fractures.

Materials and Methods:  A retrospective observational study was conducted on 114 TLS patients aged 16-75 years with known cases of TLS fracture. Data included demographics, mechanism of injury, radiographic investigations, fracture classifications, ASIA grades, treatment types, and outcomes. Descriptive statistics were used for analysis.

Results:  The current study found that the majority of patients were male (64%) and aged 20-29 years (36%). Falls from height were the leading mechanism of injury. AO classification revealed a predominance of A1 (26.3%) and A2 (21.9%) fractures. ASIA A (complete neurological deficits) was found in 35.1% of patients, and ASIA E (no neurological deficit) in 31.6%. Conservative treatment was employed in 55.3% while 44.7% of patients underwent surgery, mostly through a posterior approach. Common complications included spinal cord compression (35.1%), pressure sores (21.9%), and neuropathic pain (13.2%). Overall, 70% of patients showed good recovery.

Conclusion:  The study concluded that posterior surgical intervention is preferred, yielding favorable outcomes. Hence, early diagnosis and appropriate interventions are also crucial for minimizing complications and improving prognosis.