ABSTRACT

Purpose:

The aim of this study was to determine whether early surgical intervention in unstable thoracolumbar vertebral fractures affects the restoration of the spinal canal, neurological recovery and clinical results.

Materials and methods:

In this study, 58 cases were analyzed retrospectively. The follow-up duration was a minimum of three years. The patients were divided into three groups according to surgery times. Group I (n=31) consisted of patients who had surgery within the first 24 hours, group II (n=18) consisted of patients who had surgery within the first 24 to 96 hours, and group III (n=9) consisted of patients who had surgery after the 96th hour. The mean time interval between trauma and surgery was found to be 5.2 days (5 hours–19 days). Neurological evaluations of the cases were performed according to the Frankel classification. The patients’ pain and occupational conditions were evaluated in their final follow-up using Denis’ pain and work scale.

Results:

The postoperative spinal canal compression rates were significantly decreased in all groups when compared to the preoperative period, but the most apparent decrease was observed in group I (p<0.05). While no recovery was observed in three of the ten patients who showed complete neurological deficit, seven patients who were classified as Frankel A showed some degrees of recovery, and it was observed that these patients were operated on within 6–24 hours.

Conclusion:

This study shows that in unstable thoracolumbar vertebral fractures, early surgical treatment and adequate posterior stabilization significantly decrease the spinal canal compression, and provide some degree of neurological recovery and the early return of the patient to social activities.