Immediate Outcomes of Surgical Treatment of Patients with Uncomplicated Fractures of the Thoracic and Lumbar Spine

RELEVANCE The problem of choosing the optimal treatment method for patients with uncomplicated fractures of the thoracic and lumbar spine remains open.

AIM To present an analysis of the immediate outcomes of various surgical treatment methods: transpedicular fixation (open and percutaneous), spinal canal decompression, anterior and combined spinal fusion.

MATERIALS AND METHODS The study is based on a retrospective analysis of the data of 377 patients operated on in 2009-2022. The average age was 40.5. Radiological parameters (Cobb angle, vertebral height, degree of spinal canal stenosis), complications, duration of hospitalization, and clinical outcomes were evaluated.

RESEARCH RESULTS The results showed that transpedicular fixation (percutaneous or open) demonstrated minimal invasiveness, and reduced the duration of operations and hospitalization. Decompression of the spinal canal increased the degree of restoration of its lumen, but increased intraoperative blood loss and the duration of the intervention. Anterior access was effective for correcting kyphotic deformity; and combined operations were more often used for severe types of injuries. The overall complication rate was 15.5% including somatic and surgical complications. Serious complications were more often observed in complex interventions; and percutaneous fixation tended to decrease them. Improvement was achieved in 93.1% of patients at the time of discharge.

CONCLUSIONS The conclusions of the work indicate the need for an individual approach to the choice of surgical tactics based on the X-ray characteristics of the injury and the patient’s condition.

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