Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study

Introduction: Thoracolumbar fracture-dislocations from high-energy trauma are severe injuries requiring surgical stabilization. The risks faced by neurologically intact patients remain unclear. Objectives: To compare early complication rates in surgically treated patients with thoracolumbar fracture...

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Autores principales: Ricciardi, Guillermo, Cirillo, Ignacio, Pons Belmonte, Rodrigo, Cabrera, Juan Pablo, Guiroy, Alfredo, Carazzo, Charles, Yurac, Ratko, Ricciardi, Guillermo A., Cirillo Totera, Ignacio, ¨Pons Belmonte, Rodrigo, Carazzo, Charles A.
Formato: Artículo revista
Lenguaje:Inglés
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2026
Materias:
spine
multiple trauma
thoracic vertebrae
spinal cord injuries
thoracolumbar
trauma
neurological damage
columna vertebral
traumatismo múltiplo
vértebras torácicas
traumatismos da medula espinal
coluna vertebral
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/48345
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
Descripción
Sumario:Introduction: Thoracolumbar fracture-dislocations from high-energy trauma are severe injuries requiring surgical stabilization. The risks faced by neurologically intact patients remain unclear. Objectives: To compare early complication rates in surgically treated patients with thoracolumbar fracture-dislocations according to neurological status. Methods: This retrospective multicenter cohort study included patients from 24 institutions in 9 Latin American countries who underwent surgery for thoracolumbar fracture-dislocation between 2015 and 2023. Eligible patients were aged ≥16, of any gender, with high-energy trauma requiring surgery. The primary outcome was early postoperative complications from admission to discharge or death, with patients categorized by neurological injury at admission. Results: A total of 262 patients were analyzed, primarily young men (n=212; 80.6%) with a mean age of 36.8 years (SD=13.7). The thoracic and thoracolumbar regions were most affected. Only 18% had no neurological damage, and over half with deficits had complete spinal cord injuries. A total of 268 complications were identified (median=1; range 0–9). Postoperative complications occurred in 28.6% of patients without neurological injury and 74.3% with neurological injury (p<0.001). Neurological injury was strongly associated with complications (OR=7.4; 95% CI=3.6–15.4; p<0.001), and clinical instability also had a significant association (OR=3.2; 95% CI=1.6–6.4; p=0.001). Conclusions: Patients with neurological damage face a markedly higher risk of early postoperative complications after thoracolumbar fracture-dislocation surgery. Results may have limited generalizability due to non-probabilistic institutional sampling. 

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