NEUROLOGICAL OUTCOMES IN PATIENTS WITH THORACOLUMBAR VERTEBRAL FRACTURES AND MOTOR DEFICITS UNDERGOING EARLY SURGICAL STABILIZATION
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Keywords
Thoracolumbar fractures, spinal cord injury, motor deficits, early surgical stabilization, neurological outcomes, ASIA scale.
Abstract
Introduction: Thoracolumbar vertebral fractures are among the most common spinal injuries, often leading to significant neurological impairment. Thoracolumbar vertebral fractures represent a significant proportion of spinal trauma cases, accounting for nearly 90% of all spinal injuries, with T11 to L2 being the most frequently involved segments due to biomechanical vulnerability. The optimal timing for surgical stabilization remains a subject of clinical debate, particularly in patients presenting with motor deficits.
Objective: This study aims to evaluate the neurological outcomes in patients with thoracolumbar vertebral fractures and associated motor deficits undergoing early surgical stabilization within 72 hours of injury.
Methodology: A retrospective cohort study was conducted involving 72 patients with traumatic thoracolumbar fractures and motor deficits who underwent early surgical stabilization at Sughra Shafi Medical Complex between January 20124 and December 2024. Data were collected on demographics, injury characteristics, surgical details, and neurological outcomes using the American Spinal Injury Association (ASIA) Impairment Scale. Neurological improvement, perioperative complications, and functional recovery were assessed at 6-month and 12-month follow-ups.
Results: Among the 72 patients, 61.1% demonstrated at least one grade improvement on the ASIA scale at 6 months, with 69.4% showing improvement by 12 months. The majority of improvements occurred in patients with incomplete spinal cord injuries (ASIA B-D). Early surgical stabilization was associated with reduced hospital stay and a lower incidence of pressure sores and pulmonary complications.
Conclusion: Early surgical stabilization within 72 hours in patients with thoracolumbar vertebral fractures and motor deficits is associated with favorable neurological and functional outcomes, particularly in those with incomplete injuries. Early intervention may mitigate secondary injury mechanisms and enhance recovery potential.
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Muhammad Zeb Khan
Associate Professor, Department of Orthopaedic & Spine Surgery, Sahara Medical College, Sughra Shafi Medical Complex, The Sahara University Narowal, Pakistan
Fazal Khaliq
Senior Registrar, Department of Neurosurgery, Sahara Medical College, Sughra Shafi Medical Complex, The Sahara University Narowal, Pakistan
Shahid Mehmood
Assistant Professor, Department of Neurosurgery, Sahara Medical College, Sughra Shafi Medical Complex, The Sahara University Narowal, Pakistan
Mujtaba Afzal Khan
Senior Registrar, Department of Orthopaedic & Spine Surgery, Bahawal Victoria Hospital Bahawalpur, Pakistan
Malik Muhammad Yassin Awan
Associate Professor, Department of Orthopaedic & Spine Surgery, Sahara Medical College, Sughra Shafi Medical Complex, The Sahara University Narowal, Pakistan
Muhammad Arshad Ghani
Consultant Orthopaedic Surgeon, Department of Orthopaedic, DHQ Hospital Sheikhupura, Pakistan