Turkish Neurosurgery 2016 , Vol 26 , Num 3
Timing of Surgery for Spinal Fractures Associated with Systemic Trauma: A Need for a Strategic and Systemic Approach
Ismet KOKSAL1, Fatih ALAGOZ2, Haydar CELIK3, Ali Erdem YILDIRIM2, Tezcan AKIN4, Yahya GUVENC5, Mete KARATAY3, Yavuz ERDEM3
1Yenimahalle State Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey
2Ankara Numune Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey
3Ankara Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey
4Ankara Numune Education and Research Hospital, Department of General Surgery, Ankara, Turkey
5Sincan State Hospital, Department of Neurosurgery, Ankara, Turkey
DOI : 10.5137/1019-5149.JTN.13192-14.0 AIM: An underestimated evaluation of systemic organs in cases with spinal fractures might jeopardize the intervention for treatment and future complications with an increased morbidity and mortality are almost warranted. In the present study, a retrospective analysis of spinal fracture cases associated with systemic trauma was performed to assess surgical success.

MATERIAL and METHODS: A retrospective analysis of patients with thoracolumbar fractures who were admitted to the emergency unit between September 2012 and September 2014 was used for the study. The cases were categorized according to age, sex, reason of trauma, associated trauma, neurological condition and treatment details and results were analysed using SPSS 14.0 for Windows.

RESULTS: The most common reason of trauma is detected as falls in 101 cases (64.3%). Radiological evaluation of spinal fractures revealed a compression fracture in 106 cases (67.5%) and other fractures in 51 cases (32.5%). Surgical treatment for spinal fracture was performed in 60.5% of the cases and conservative approach was preferred in 39.5% cases. In non-compressive spinal fractures, an associated pathology like head trauma, lower extremity fracture or neurological deficit was found to be higher in incidence (p<0.05). Necessity for surgical intervention was found to be more prominent in this group (p<0.05). However, the fracture type was not found to be associated with morbidity and mortality (p<0.05).

CONCLUSION: A surgical intervention for a spinal fracture necessitating surgery should rather be performed right after stabilization of the systemic condition which might be associated with decreased morbidity and mortality. Keywords : Systemic trauma, Spinal fracture, Timing of surgery

Corresponding author : Haydar Celik, dr_haydarcelik@hotmail.com