MANAGEMENT AND OUTCOME OF SHORT SEGMENT TRANSPEDICULAR SCREW FIXATION AT JPMC KARACHI

Objective: To evaluate the management and outcome of lower thoracic and upper lumbar fractures and Spondylolisthesis with short segment transpedicular screw fixation at JPMC Karachi. Methods: This was a prospective type of study, conducted from April 2023 to March 2024 in Department of Neurosurgery, Jinnah Postgraduate Medical Centre Karachi. All patients admitted with thoracolumbar fractures and went under fixation with short arm transpedicular screw in that period were included and analysed. Results: In this prospective study of 54 patients (63% males, 37% females; mean age 33.22 years), vertebral fractures were primarily caused by falls from height (44.4%) and road traffic accidents (29.6%). Most patients (70.4%) had fracture-only injuries, predominantly at the thoracolumbar junction (T12-L2) and presented with wedge compression fractures (48.0%) or burst fractures (20.0%). Postoperatively, 59.3% of patients were pain-free, with 60.0% achieving ASIA Grade E neurological status. Physiotherapy was undertaken by 52.4% of patients, with 15.8% returning to their previous job post-surgery. Overall, 7.4% of patients expired. The study findings were statistically significant (p < 0.05). Conclusion: Short arm Transpedicle Screw fixation has modified the management and outcome of lower thoracic and lumbar fractures with spondylolisthesis. It has improved neurologic status and quality of life of patients.