Single-Stage Versus Two-Stage 360° Stabilization Procedure in Unstable Thoracolumbar Burst Fractures - A...

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Spine Surgery

Background:

• Unstable thoracolumbar burst fractures often require circumferential (360°) stabilization.
• Debate exists regarding the optimal surgical approach: single-stage versus two-stage procedures.

Purpose of the Study:

• To compare the efficacy of single-stage versus two-stage 360° stabilization for unstable thoracolumbar fractures.
• To determine which approach leads to a shorter hospital length of stay.

Main Methods:

• Retrospective quasi-experimental study at two Level I trauma centers (6-year period).
• Included non-polytraumatized adults (ISS ≤15) with unstable thoracolumbar fractures undergoing 360° stabilization.
• Primary outcome: total hospital length of stay. Secondary outcomes: operative time, blood loss, mortality.

Main Results:

• 184 patients analyzed (104 single-stage, 80 two-stage).
• Single-stage group had significantly shorter hospital stays (9 vs. 11 days; P < 0.001).
• Single-stage also showed reduced operative time (194 vs. 230 min; P = 0.003) and blood loss (500 vs. 750 mL; P = 0.033).

Conclusions:

• Single-stage 360° stabilization is superior to the two-stage approach for unstable thoracolumbar fractures in non-polytraumatized patients.
• The single-stage method offers significant benefits in reduced hospital stay, operative time, and blood loss.
• Preference should be given to single-stage procedures when clinically feasible.