Abstract :
Introduction: Spinal cord injury (SCI) following trauma is a functional, psychological and socioeconomic disorder, results in serious secondary medical complications with increased morbidity and mortality. In most of the cases it leads to increased hospitalization, loss of employment and decreased quality of life.
Aims & Objectives: To observe and compare the outcome of conservative and operative methods of treatment in patients of traumatic paraplegia due to spinal cord injury.
Materials and Methods: This was an analytical, case control, prospective study. Twenty-one consecutive patients of spinal cord and spinal column injuries of age between 10 to 60 years and both the gender were included. Using Thoracolumbar Injury Classification and Severity Score (TLISS) they were divided into conservative group (n=13, TLISS score ?3 and 4) and operative group (n=8, TLISS score ?5). Follow up was done on 3rd week, 12th week, 24th week and 36th weeks of treatment.
Results: Most of the patients in this study were in 31-40 years, male, from rural area, injured due to fall from height. Out of 13 patients treated conservatively, 7 had excellent, 4 had good, and 2 had bad outcome according to clinical and radiological findings at the end of follow up months. There was no significant difference in sensory control, motor control, bladder/bowel voluntary control and complications among patients undergone conservative and operative treatment. But the radiological findings for deformity correction was significantly higher among patients undergone operative treatment with respect to conservative treatment.
Conclusions: In this study operative management of spinal cord injury was more efficacious, more compliant but had similar co-morbidity with respect to conservative management. But on the basis of treatment cost and complications conservative management is mostly preferred in rural areas.
Keyword :
Traumatic paraplegia, Thoracolumbar injury severity score (TLISS), Plaster jacket and other thoracolumbar orthosis (TLOS), Pedicle screw fixation (PSF), Hard shill fixation (HSF).