ArticleJournal of clinical orthopaedics and trauma2021
Timing of intervention for spinal injury in patients with polytrauma.
Article in Journal of clinical orthopaedics and trauma, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Early versus delayed fixation of maxillofacial fractures in polytrauma: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Epidemiology of spinal fractures in polytrauma patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Severe trauma care: advances and future directions in diagnostic and therapeutic techniques and information technology support.Medical review (2021) · 2026Article
- Acute management of spinal fractures: What you need to know.The journal of trauma and acute care surgery · 2026Review
- Hybrid TEVAR and REBOA procedures prior to fracture reduction and fixation in a displaced C-type thoracic spine fracture with bony contact to the aorta - A case report.International journal of surgery case reports · 2025Article
- A case of damage control after polytrauma and bilateral femur fracture.Trauma case reports · 2024Article
- Traumatic thoracolumbar spondyloptosis of T12-L1 with stable hemodynamics: A case report.International journal of surgery case reports · 2024Article
- Catalytic antioxidant nanoparticles mitigate secondary injury progression and promote functional recovery in spinal cord injury model.Journal of controlled release : official journal of the Controlled Release Society · 2023Article
- A Comparison of Outcomes between the Wiltse Approach with Pedicle Screw Fixation and the Percutaneous Pedicle Screw Fixation for Multi-Segmental Thoracolumbar Fractures.Orthopaedic surgery · 2023Article
- The sequence of the treatment of combined fractures of the pelvis, spine, and extremities in polytraumatized patients.EFORT open reviews · 2023Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe optimal timing of surgical intervention of spinal fractures in patients with polytrauma is still controversial. In the setting of trauma to multiple organ systems, an inappropriately timed definitive spine surgery can lead to increased incidence of pulmonary complications, hemodynamic instability and potentially death, while delayed surgical stabilisation has its attendant problems of prolonged recumbency including deep vein thrombosis, organ-sp ecific infection and pressure sores.
methodsA narrative review focussed at the epidemiology, demographics and principles of surgery for spinal trauma in poly-traumatised patients was performed. Pubmed search (1995-2020) based on the keywords -
resultsSpine trauma is noted in up to 30% of polytrauma patients. Unstable spinal fractures with or without spinal cord injury in polytrauma require surgical intervention and are treated based on the following principles - stabilizing the injured spine during resuscitation, acute management of life-and limb-threatening organ injuries, "damage control" internal stabilisation of unstable spinal injuries during the early acute phase and, definitive surgery at an appropriate window of opportunity. Early spine fracture fixation, especially in the setting of chest injury, reduces morbidity of pulmonary complications and duration of hospital stay.
conclusionRecognition and stabilisation of spinal fractures during resuscitation of polytrauma is important. Early posterior spinal fixation of unstable fractures, described as damage control spine surgery, is preferred while a delayed definitive 360° decompression is performed once the systemic milieu is optimal, if mandated for biomechanical and neurological indications.
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