ArticleRevista de la Facultad de Ciencias Medicas (Cordoba, Argentina)2026
Complication rates in thoracolumbar fracture-dislocations with and without neurological injury.
Article in Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThoracolumbar fracture-dislocations from high-energy trauma are severe injuries requiring surgical stabilization. The risks faced by neurologically intact patients remain unclear.
objectivesTo compare early complication rates in surgically treated patients with thoracolumbar fracture-dislocations according to neurological status.
methodsThis retrospective multicenter cohort study included patients from 24 institutions in 9 Latin American countries who underwent surgery for thoracolumbar fracture-dislocation between 2015 and 2023. Eligible patients were aged ≥16, of any gender, with high-energy trauma requiring surgery. The primary outcome was early postoperative complications from admission to discharge or death, with patients categorized by neurological injury at admission.
resultsA total of 262 patients were analyzed, primarily young men (n=212; 80.6%) with a mean age of 36.8 years (SD=13.7). The thoracic and thoracolumbar regions were most affected. Only 18% had no neurological damage, and over half with deficits had complete spinal cord injuries. A total of 268 complications were identified (median=1; range 0-9). Postoperative complications occurred in 28.6% of patients without neurological injury and 74.3% with neurological injury (p<0.001). Neurological injury was strongly associated with complications (OR=7.4; 95% CI=3.6-15.4; p<0.001), and clinical instability also had a significant association (OR=3.2; 95% CI=1.6-6.4; p=0.001).
conclusionsPatients with neurological damage face a markedly higher risk of early postoperative complications after thoracolumbar fracture-dislocation surgery. Results may have limited generalizability due to non-probabilistic institutional sampling.
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