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Abstract
Aim of this study was to assess neurological improvement after surgical intervention
in cases of traumatic paraplegia classified by Frankel scoring. A retrospective study
of operated cases of traumatic paraplegia over a period of fifteen months (Jan 2009
to March 2010) was carried out at Jai Prakash Narayan Apex Trauma Centre, AIIMS, New
Delhi. The analysis included a total of 66 cases of paraplegia (Frankel A or B). Data
collected from patient records included age, sex, time from injury to hospitalization,
initial neurological status as per Frankel Score, MRI findings, surgery performed,
postoperative course and neurological status at the time of discharge and latest follow
up. Patients lost to follow up were not studied for outcome analysis. SPSS 16 was
used for the statistical analysis.
The mechanism of injury was fall from height in 56.1 % (n=37) cases. & Road Traffic
accident in 30.3% (n=20) cases. Median interval from time of injury to admission was
2 days (range, 0–75days). The most common site of injury was D11 to L1 in 57.57% (n=38)
cases. Decompression and long segment pedicular fixation with bony fusion was the
most common procedure performed. Median follow up period was six months (range, 1–12months).
Sixty two percent (n=41) were lost to follow up. Forty four percent (n=11/25) improved
on continued follow up till August 2010. and 16% (n=4/25) improved to useful motor
score Frankel D or E.
Traumatic paraplegia patients need a holistic approach. Instrumentation of spine facilitates
early mobilization and adds to the ease of rehabilitation. The decision of operative
management should be case based.
Keywords
traumatic paraplegia - decompression - posterior fixation
