Optimization of Surgical Treatment for Traumatic Injuries of the Thoracolumbar Spine Complicated by Neurological Deficit
Keywords:
thoracolumbar spine, complicated injury, spinal cord trauma, transpedicular fixation, decompression, electrical stimulationAbstract
Complicated thoracolumbar spine injuries accompanied by spinal cord damage remain a significant challenge in clinical practice due to their high rates of long-term disability and the complexity of managing them. Often resulting from high-energy trauma such as motor vehicle accidents or falls from height, these injuries can lead to severe neurological deficits including paraplegia or quadriplegia depending on the level and severity of the injury. The optimal treatment strategy is controversial as it requires careful consideration of the balance between spinal stabilisation, neural decompression and functional recovery. Against this backdrop, the present study sought to evaluate the surgical outcomes of 176 patients with complex thoracolumbar spine trauma who were treated at a specialised neurosurgical centre over a defined period. Patients were stratified into distinct groups according to the surgical approach chosen, including transpedicular fixation, decompressive laminectomy and combined procedures incorporating both stabilisation and decompression techniques. Adjunctive postoperative electrical stimulation was employed in selected cases. Neurological assessment was systematically performed using the ASIA/IMSOP scale, enabling objective quantification of motor and sensory recovery. The study findings indicate that patients undergoing combined surgical interventions demonstrated significantly greater neurological improvement and enhanced functional outcomes compared to those treated with stabilisation or decompression methods alone. Furthermore, the results suggest that early and comprehensive surgical management, particularly when combined with adjunctive therapies, may facilitate favourable long-term recovery, reduce the risk of secondary complications and improve quality of life. These observations emphasise the importance of personalised, multidisciplinary treatment planning in managing complicated cases.
Furthermore, the results suggest that early and comprehensive surgical management, particularly when combined with additional therapies, may lead to a more favourable long-term recovery and reduce the risk of secondary complications. This approach can also improve overall quality of life. These findings highlight the importance of personalised, multidisciplinary treatment planning in managing complicated thoracolumbar spine injuries.
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