Perioperative complications in spinal trauma patients: does timing matter?

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Neurosurgery

Background:

• Early surgical intervention in traumatic spinal fractures aims to enable prompt patient mobilization.
• However, the safety and benefits of early surgery in spinal trauma patients remain under investigation.
• This study examines the impact of surgical timing on perioperative complications.

Purpose of the Study:

• To investigate the effect of surgical timing on perioperative complications in patients with traumatic spinal fractures.
• To identify risk factors associated with perioperative complications in spinal trauma surgery.
• To compare early, late, and delayed surgical treatment outcomes.

Main Methods:

• Retrospective analysis of 394 spinal trauma patients undergoing surgery between 2010-2020.
• Patients were categorized into early (<24h), late (24-72h), and delayed (>72h) surgical groups.
• Perioperative complications were the primary outcome, with analysis of patient and trauma-specific factors.

Main Results:

• Perioperative complications were linked to age, BMI, comorbidities, ASA grades 3-4, spinal cord injury (SCI), AO Spine type C, chest injury, and surgical delay.
• Multivariable analysis identified age, ASA category, AO Spine classification, and SCI as significant risk factors.
• In non-SCI patients, delayed surgery was associated with increased perioperative complications.

Conclusions:

• Delayed surgical treatment may lead to more perioperative complications in non-SCI patients compared to early surgery.
• Older age, higher ASA grades (3-4), AO Spine type C injury, and SCI are potential risk factors for complications.
• Surgical timing is a critical consideration in managing traumatic spinal fractures.