[Does timing of thoracic spine stabilization influence perioperative lung function after trauma?]

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Neurosurgery

Background:

• The optimal timing for surgical stabilization of thoracic spine injuries remains controversial.
• Early fracture repair in long bones is associated with reduced complications, but this is less established for spinal injuries.

Purpose of the Study:

• To evaluate the safety and efficacy of early surgical stabilization for thoracic spine fractures.
• To compare perioperative lung function and intensive care unit (ICU) stay in patients undergoing early versus delayed stabilization.

Main Methods:

• Retrospective analysis of 48 patients with thoracic spine fractures treated with ventrodorsal stabilization.
• Patients were divided into three groups based on timing of stabilization and presence of lung contusion.
• Surgical technique involved prone positioning, single-step dorsal stabilization with transpedicular fixation, and ventral fusion via minimally invasive thoracotomy.

Main Results:

• Procedure durations and intraoperative blood loss were comparable across groups.
• Early stabilization (Groups I and III) showed improved PaO(2)/FiO(2) ratios, while Group II experienced perioperative lung function impairment.
• Overall ICU stay tended to be shorter in the early stabilization group (Group I).

Conclusions:

• Early stabilization of combined thoracic and spine injuries is safe.
• This approach does not negatively impact perioperative lung function.
• Early surgical intervention leads to a reduced overall ICU stay for patients with thoracic spine injuries.