Science Letters

Comparison of the outcomes of operative versus non-operative treatments for thoraco-lumbar fractures with neurological deficit

Sayeed Uddin Helal 1, Reshma Parvin Nuri 1, Mohammed Abdul Baseer 2, Abdur Rahman 2

1 Centre for the Rehabilitation of the Paralyzed (CRP), Dhaka, Bangladesh

2 First Affiliated Hospital, Zhengzhou University, Henan, PR China.

Abstract

The aim of this study was to explore the outcome of operative and non-operative treatment for thoraco-lumbar fractures with neurological deficit. This is a retrospective analysis cross-sectional study performed on 27 patients. Among them, 14 (52%) received spinal fixation and of which 1 patient died during operation and 13 (48%) patients received conservative treatment. The mean age of the patients was 30 years (SD 11.85). The mean length of hospital stay was 117.6 days (SD 48.66 days) in surgical group, while that of non-surgical group was 93.38 days (SD 33.28 days), in which difference was not statistically significant (t = 1.482 and P = 0.153). The Delay consent giving was the probable major cause of long time hospital stay for the surgical group. We found a significant association between treatment modalities and neurological outcome of the patients (P=0.05). Spinal fixation showed better neurological recovery (t = 2.42 and P = 0.032). There was no patient worsened neurologically till the time of discharge in both groups. Surgical and conservative, both treatments, significantly reduced the pain score in the fracture area (P=0.0001). There was no significant difference on the functional outcome after therapy between two groups (P=0.183). Treatment cost was higher for those who went under surgical management. Early surgical management is preferable for quick and better neurological outcomes.

Keywords: Spinal cord injury, thoraco-lumbar fracture, outcome, spinal fixation, neurological deficit, spine surgery.

Received February 3, 2015 Revised March 29, 2015 Published online first April 30, 2015

*Corresponding author Sayeed Uddin Helal Email sayeedhelal@ymail.com