Prof. Shahzad Shams presently works as Head and Professor of Neurosurgery Department at Lahore General Hospital, LGH, Lahore.
Treatment of Spine Injuries
Early stabilization by fixation reduces the incidence of complications from bed rest, such as pressure sores, pneumonia and thrombophlebitis, the patient has less pain and can participate in rehabilitation and mobilization at an earlier stage, thus reducing hospital time and cost. Depending on the type of instability, fixation can be achieved using either an external orthosis such as a halo device or by internal means. The latter can be achieved in a variety of ways according to the type of injury. These include metal wire, clamps, pedicle screws or anterior vertebralplates, in combination with bone grafting.
Thoracolumbar fracture-dislocations are usually relatively stable compared with cervical injuries, and if the patient is moved with care, and nursed in slight hyperextension with a pillow in the small of the back, most remain reduced. When there is instability, and particularly if the lesion is incomplete and could therefore be made worse, decompression of the spinal canal followed by internal fixatin and bone grafting to restore the normal thoraco-lumbar curve is advised. Several effective methods are available for anterior, lateral or posterior fixation.