Predictors of postoperative neurological deficits in traumatic thoracolumbar fractures

The goal of this retrospective study was to assess the outcomes of vertebral stabilization following acute traumatic thoracolumbar (TL) fractures.

The study examined the mechanism and location of trauma, pre-operative and post-operative neurological deficits, stabilization level, screw malposition, cerebrospinal fluid fistula, development of post-operative infections, additional pathological findings, mobilization times, and follow-up durations.

The study included 55 patients. Falls were the leading cause of trauma (75%), and L1 was the most common fracture site (30.9%). A4 was the most common fracture type (61.8%), with T11-L3 being the most frequently stabilized level (32.7%). Screw malposition occurred in 3.6% of cases, and CSF fistula was more common in types B and C. The presence of pre-operative neurodeficits and TL American Orthopedic Spine Injury Score (AOSIS) type B and C significantly increased the risk of post-operative neurological complications. Univariate analysis showed that pre-operative neurodeficits (odds ratio [OR]: 396, 95% confidence intervel [CI]: 22-6935, p < 0.001) and TL AOSIS types B (OR: 11.78, 95% CI: 1.88-73.58, p = 0.008) and C (OR: 9.9, 95% CI: 1.31-74.73, p = 0.026) significantly increased the risk of post-operative neurodeficits.

This study, therefore, takes into consideration the strong impact of pre-operative neurological deficit and injury severity with respect to TL classifications on post-operative outcomes for patients undergoing surgical stabilization for traumatic fractures.