Effectiveness of Posterior Decompression and Internal Fixation in Emergency Management of Thoracolumbar Fractures Complicated by Spinal Cord Injury.

Abstract

Objective: This study evaluates the effectiveness and timeliness of posterior decompression and internal fixation in the emergency management of thoracolumbar fractures complicated by spinal cord injuries. Methods: We retrospectively analyzed 40 patients treated at our hospital from January 2019 to February 2022. Each patient underwent posterior decompression and internal fixation, with preoperative and postoperative assessments including vertebral body height, American Spinal Injury Association (ASIA) score, Visual Analog Scale (VAS) score, and urodynamic indices. Results: Postoperative improvements were noted in vertebral body height, with anterior and posterior heights increasing to 12.82 (± 1.23) mm and 3.21 (± 0.64) mm, respectively, and kyphosis angle improving to 14.26 (± 0.32). Significant enhancements were also observed in motor (from 40.78 [± 4.32] to 59.86 [± 1.37]) and sensory (from 45.98 [± 3.20] to 66.92 [± 1.28]) function scores, and a reduction in VAS score from 6.89 (± 0.78) to 1.78 (± 0.32). Urodynamic measurements showed increased maximum urine flow and detrusor pressure postintervention. All surgical wounds healed within two weeks without significant complications. Conclusion: Posterior decompression and internal fixation significantly improve spinal stability, pain, motor, and sensory functions in patients with thoracolumbar fractures and spinal cord injuries, demonstrating its effectiveness and clinical utility.