International Journal of Research in Orthopaedics | October-December 2015 | Vol 1 | Issue 1 Page 3 International Journal of Research in Orthopaedics Ram GG et al. Int J Res Orthop. 2015 Dec;1(1):3-6 http://www.ijoro.org Research Article Outcome analysis of surgically managed unstable burst fracture Ganesan G. Ram*, P. V. Vijayaraghavan, Kannan Karthik Kailash INTRODUCTION The Dorsolumbar junction is the most common site for non-osteoporosis related spinal column fractures. Dorsolumbar segment of spine is an unstable zone between fixed dorsal and mobile lumbar spine. A wide variety of injury patterns and clinical presentations are encountered. Although Dorsolumbar junction has a higher risk for fracture, it has important anatomic characteristics that allow for a greater recovery from neurologic injury than more cephaloid cord injuries. The site has also been the most extensively studied, including development and treatment. In addition there is no universally accepted classification of spinal fractures that identify those who will require surgery to prevent late deformity or neurologic compromise. Burst fractures are common injuries of dorsolumbar spine. In indicated cases, surgery is the treatment of choice. Significant controversy exists regarding surgical intervention for these fractures. Among all surgeries anterior decompression is ideal not only because of compression anteriorly are relieved but also maintains the ABSTRACT Background: Burst fractures are common injuries of dorsolumbar spine. In indicated cases, surgery is the treatment of choice. Significant controversy exists regarding surgical intervention for these fractures. Posterior decompression, anterior decompression and instrumentation, and combined anterior decompression and posterior instrumentation have been recommended in various studies. Here we are going to evaluate unstable burst fractures of thoracic and lumbar spine treated by isolated anterior decompression and instrumented fusion with TSM-Bone graft composite. Methods: Prospective study of thirty-six cases of unstable fracture of thoracic and lumbar spine treated in Sri Ramachandra Medical centre from January 2011 to January 2014. The inclusion criteria were burst fractures of thoracic or lumbar spine complete or incomplete neurological deficit and burst fractures of thoracic or lumbar spine without neurological deficit but with mechanical instability. The exclusion criteria were pathological fractures, chance fracture, stable burst, wedge compression and osteoporotic compression fractures. The results were analyzed during the follow-up using the Pain – Visual analogue scale, Fusion status and radiographic parameter – K-angle .For pain score were given as 3,2,1 for absent, moderate and severe pain respectively. Regarding fusion status score of 3,2,1 were given when fusion was good, fair and no sign of fusion respectively. Results: Mean pre-operative K-angle was 28o. Average loss of correction at final follow up was 3o.Mean correction of K-angle was 140.Moderate to severe loss of correction of K- angle was observed in 4 patients. Mild to moderate pain in 5 patients treated with analgesics. Average TSM subsidence was 3mm. Conclusions: Bone graft composite provides stable biomechanical support to deficient anterior column in burst fractures and allows early rehabilitation and mobilization. Neural recovery may occur after anterior decompression, stabilization and fusion with TSM-Bone graft composite in dorsolumbar burst fractures with incomplete cord injury. Keywords: Burst fracture, TSM-Bone graft, Anterior decompression, Neurological deficit Department of Orthopaedics, Sri Ramachandra Medical College, Porur, Chennai, India Received: 01 October 2015 Accepted: 21 November 2015 *Correspondence: Dr. Ganesan G. Ram, E-mail: ganesangram@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20160340