IMPROVEMENT IN ASIA GRADES AT 6 MONTHS FOLLOW-UP OF ACUTE THORACOLUMBAR JUNCTION (TLJ) SPINAL INJURY

Abstract

Background:The incidences of injuries to spinal cord are on a rise and the impact on the health care system and economy is tremendous. Epidemiological research has demonstrated that SCI affects 10 to 40 persons per million populations per annum in developed countries.Objective: To study and evaluate the Improvement In ASIA Grades At 6 Months Follow-Up Of Acute Thoracolumbar Junction (TLJ) Spinal Injury. Materials and Methods: A prospective observational study at Department of Orthopedic surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh with all patients with thoracolumbar junction (TLJ) spine injury, attending our hospital within a week of injury during a period of November 2018 to August 2020 were included for analysis. ASIA grade, thoraco lumbar injury classification and severity score (TLICS), imageological factors on MRI and timing of intervention were studied. Change in neurological status by one or more ASIA grade from the date of admission to 6months follow up was taken as improvement. Functional grading was assessed using functional independence measure (FIM) scale at 6months follow up. Results: A total of 25 patients with acute thoracolumbar junction (TLJ) spine injury, managed surgically were included in this study. Follow up was available for all patients at 6months. No improvement was noted in patients with ASIA grade A. Maximum improvement was noted in ASIA D group (83.3%). Patient with cord contusion showed mild improvement as opposed to those with just oedema wherein the improvement was seen in 75% patients. Maximum improvement in FIM score was noted in ASIA grade D and patients who had oedema in MRI TLJ spine. Conclusions: Incomplete spinal cord injury, patients showing MRI oedema have good improvement in neurological status at 6months follow up.