Traumatic multiple-level continuous and noncontinuous thoracolumbar spinal fractures management in adult patients: A single-center experience.

Abstract

Background: This study aimed to describe our clinical experience with surgical approaches and patient management for traumatic multiple-level continuous and noncontinuous thoracolumbar spinal fractures.

Methods: We retrospectively evaluated patients with continuous and noncontinuous multiple-level thoracolumbar fractures who were operated on by the same surgical team from 2019 to 2021. These patients were divided into two groups: Group 1 (n=12, continuous fractures) and Group 2 (n=14, noncontinuous fractures). We assessed the patients' age, gender, fracture levels, fracture type, classification according to the AO (Arbeitsgemeinschaft für Osteosynthesefragen) Spine Thoracolumbar Fracture Classification, status of posterior ligament damage, presence of additional traumatic pathology, status of decompression via laminectomy, levels of stabilization and fusion, preoperative and postoperative neurological status, presence of cervical trauma, duration of operation, amount of blood loss, duration of hospitalization, and lordosis and kyphosis angles in terms of fusion status and postoperative follow-up over two years. The study excluded patients over the age of 65, those with single-level fractures, and pathological fractures caused by osteoporosis, infection, or spinal tumors.

Results: Gender, age, neurological status, application of laminectomy, surgical complications, status of cervical fracture, duration of operation, amount of blood loss, duration of hospitalization, lordosis, and kyphosis angles were uniformly distributed between the groups. All patients underwent fusions, ranging from three to eight, with a median of two (range 2-4) fracture levels, and a median of five instrumented vertebrae, ranging from four to seven. Significant differences between the two groups were observed in terms of operation duration (p=0.001), blood loss (p=0.010), duration of hospitalization (p=0.003), number of fusions (p<0.001), and instrumented vertebral segments (p=0.011).

Conclusion: Thus, a surgical approach involving decompression, vertebral fusion screws, allografts, and bone substitutes can enhance surgical outcomes for patients with continuous and noncontinuous vertebral fractures.