Operative treatment of 733 patients with acute thoracolumbar spinal injuries: comprehensive results from the second, prospective, internet-based multicenter study of the Spine Study Group of the German Association of Trauma Surgery

Eur Spine J, 2010 · DOI: 10.1007/s00586-010-1451-5 · Published: May 25, 2010

Spinal Cord Injury Surgery Medical Imaging

Simple Explanation

This study examines the operative treatment of thoracolumbar spinal injuries using data from multiple trauma centers. The study aims to update previous findings and assess surgical outcomes and follow-up results. Data were collected prospectively from 733 patients across eight German and Austrian trauma centers.

Study Duration

30 months

Participants

733 patients with acute thoracolumbar (T1–L5) injuries

Evidence Level

Prospective, internet-based multicenter study

Key Findings

1
Combined posteroanterior surgery led to the best correction of posttraumatic deformity.
2
Posterior surgery resulted in better functional and subjective outcomes at follow-up compared to combined surgery.
3
Neurological deficits are the most important factors for the functional outcome and prognosis.

Research Summary

This study presents comprehensive data on a large patient population with acute thoracolumbar spinal injuries. The study updates results and presents clinical outcomes of current operative treatment strategies in German and Austrian trauma centers. The study highlights contradictory findings between subjective clinical outcomes and corresponding radiological findings across different surgical subgroups.

Practical Implications

Surgical Approach Selection

Surgeons should consider the trade-offs between deformity correction (better with combined surgery) and functional outcomes (better with posterior surgery alone) when choosing a surgical approach.

Neurological Status Emphasis

Greater attention should be given to pre-existing neurological deficits as they significantly impact overall functional outcomes.

Rehabilitation Strategies

Tailored rehabilitation programs should be implemented considering the type of surgical intervention, presence of neurological deficits and concomitant injuries to optimize patient recovery.

Study Limitations

1
The study could not answer all questions regarding contradictory findings between subjective and radiological outcomes.
2
The study was limited by the lack of long-term randomized-controlled investigations.
3
Heterogeneity in surgical techniques across different centers might influence the results.

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