Outcome of Surgical Treatment of Traumatic Vertebra Fractures With Spinal Cord Injury within 48 Hours

Background: Acute spinal cord injuries can occur as a result of vertebra fractures which can have a profound impact on the patient,family and society. They can occur due to high-energy trauma or due to innocent falls in the geriatric population .The aim of this study is to review and evaluate the outcome of patients that were admitted to our trauma unit with vertebra fractures with acute spinal cord injury and have been treated surgically within 48 hours of admission.

Materials and Methods: Retrospective study from 01/2006 to 02/2017 , medical records were retrospectively reviewed for location of vertebra fracture, mechanism of injury, associated injuries, time before surgery(less than 12 hours , 12 -24 hours, more than 24 hours), length of hospital stay , ASIA impairment scale before surgery, after surgery, and at long term follow up.

Results: 80 patients (54 males: 26 females).Mean age at admission was 37 years (range 6-95 years).The mean follow up was 35 months (range 2-115 months).51% had vertebra fractures due to motor vehicle accident while 49% due to falls.
27 % had cervical vertebra fractures, 27 % had thoracic vertebra fractures and 46 % had lumbar vertebra fractures.
53 % had associated injuries.
At long term follow up after surgery, 47 % of patients with acute spinal cord injury had been improved in their ASIA scale.
In patients who were operated in less than 12 hours since admission; 55% were improved in their ASIA score after surgery, while patients who waited for surgery 12-24 hours and more than 24 hours have 33% improvement in their ASIA score.

Conclusion: Early surgical intervention should be advised for patients with vertebra fractures and acute spinal cord injury, as it is associated with improved outcome.