Early postoperative complications of thoracolumbar fractures in patients with multiple trauma according to the surgical timing

G A Ricciardi; I G Garfinkel; G G Carrioli; S Svarzchtein; A Cid Casteulani; D O Ricciardi

doi:10.1016/j.recot.2022.07.007

Early postoperative complications of thoracolumbar fractures in patients with multiple trauma according to the surgical timing

Rev Esp Cir Ortop Traumatol. 2022 Sep-Oct;66(5):T371-T379. doi: 10.1016/j.recot.2022.07.007. Epub 2022 Jul 16.

[Article in English, Spanish]

Authors

G A Ricciardi¹, I G Garfinkel², G G Carrioli², S Svarzchtein³, A Cid Casteulani³, D O Ricciardi²

Affiliations

¹ Spine Team, Centro Médico Integral Fitz Roy, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: guillermoricciardi@gmail.com.
² Spine Team, Centro Médico Integral Fitz Roy, Ciudad Autónoma de Buenos Aires, Argentina.
³ Pelvis and Hip Trauma and Reconstruction Team, Centro Médico Integral Fitz Roy, Ciudad Autónoma de Buenos Aires, Argentina.

PMID: 35843554
DOI: 10.1016/j.recot.2022.07.007

Abstract

Introduction and objectives: Our objective was to compare the rate of complications in thoracolumbar fractures that occurred during the early postoperative period in patients with multiple high-energy trauma according to the time of surgery. As a secondary objective, to estimate which variables were associated with surgery before 72 h.

Material and methods: Retrospective analysis of a series of patients with thoracolumbar fractures and multiple associated injuries in other anatomical regions due to high energy trauma. Surgically treated in an occupational trauma referral center, by the same surgical team and during the period between January 2013 and December 2019.

Results: We analyzed a sample of 40 patients (39 men and 1 woman). The rate of complications was independent of surgical delay (before and after 72 h) (p = 0.827). There were statistically significant differences between early and later surgery groups in the variables age, systolic blood pressure, initial SOFA score and presence of neurological damage (p = 0.014; p = 0.029; p = 0.032; p = 0.012). The overall surgical delay was correlated with the SOFA score (p = 0.007).

Conclusion: The rate of early postoperative complications did not show significant differences between the early and late surgery groups. We observed that the patients who had been operated before 72 h from trauma were younger, had more association with neurological syntoms, presented higher blood pressure values and less physiological damage. Surgical delay was positively correlated with SOFA score on arrival.

Keywords: Fractura toracolumbar; Fracturas vertebrales; Momento quirúrgico; Multiple trauma; Retraso quirúrgico; Surgical delay; Surgical timing; Thoracolumbar trauma; Traumatismos múltiples; Vertebral fractures.