Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study
Introduction: Thoracolumbar fracture-dislocations from high-energy trauma are severe injuries requiring surgical stabilization. The risks faced by neurologically intact patients remain unclear. Objectives: To compare early complication rates in surgically treated patients with thoracolumbar fracture...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2026
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/48345 |
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I10-R327-article-48345 |
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| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Inglés |
| format |
Artículo revista |
| topic |
spine multiple trauma thoracic vertebrae spinal cord injuries spine thoracolumbar trauma neurological damage columna vertebral traumatismo múltiplo vértebras torácicas traumatismos da medula espinal coluna vertebral traumatismo múltiplo vértebras torácicas traumatismos da medula espinal |
| spellingShingle |
spine multiple trauma thoracic vertebrae spinal cord injuries spine thoracolumbar trauma neurological damage columna vertebral traumatismo múltiplo vértebras torácicas traumatismos da medula espinal coluna vertebral traumatismo múltiplo vértebras torácicas traumatismos da medula espinal Ricciardi, Guillermo Cirillo, Ignacio Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles Yurac, Ratko Ricciardi, Guillermo A. Cirillo Totera, Ignacio ¨Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles A. Yurac, Ratko Ricciardi, Guillermo Cirillo, Ignacio Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles Yurac, Ratko Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study |
| topic_facet |
spine multiple trauma thoracic vertebrae spinal cord injuries spine thoracolumbar trauma neurological damage columna vertebral traumatismo múltiplo vértebras torácicas traumatismos da medula espinal coluna vertebral traumatismo múltiplo vértebras torácicas traumatismos da medula espinal |
| author |
Ricciardi, Guillermo Cirillo, Ignacio Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles Yurac, Ratko Ricciardi, Guillermo A. Cirillo Totera, Ignacio ¨Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles A. Yurac, Ratko Ricciardi, Guillermo Cirillo, Ignacio Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles Yurac, Ratko |
| author_facet |
Ricciardi, Guillermo Cirillo, Ignacio Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles Yurac, Ratko Ricciardi, Guillermo A. Cirillo Totera, Ignacio ¨Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles A. Yurac, Ratko Ricciardi, Guillermo Cirillo, Ignacio Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles Yurac, Ratko |
| author_sort |
Ricciardi, Guillermo |
| title |
Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study |
| title_short |
Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study |
| title_full |
Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study |
| title_fullStr |
Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study |
| title_full_unstemmed |
Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study |
| title_sort |
complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a latin american multicenter retrospective cohort study |
| description |
Introduction: Thoracolumbar fracture-dislocations from high-energy trauma are severe injuries requiring surgical stabilization. The risks faced by neurologically intact patients remain unclear. Objectives: To compare early complication rates in surgically treated patients with thoracolumbar fracture-dislocations according to neurological status. Methods: This 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. Results: A 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). Conclusions: Patients 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. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2026 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/48345 |
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I10-R327-article-483452026-03-10T20:44:09Z Complication rates in thoracolumbar fracture-dislocations with and without neurological injury: a Latin American multicenter retrospective cohort study Complicaciones en las fracturas-luxaciones toracolumbares con y sin compromiso neurológico: estudio de cohorte retrospectivo multicéntrico en América Latina Complicações associadas às fraturas-luxações toracolombares com e sem lesão neurológica: estudo de coorte retrospectivo multicêntrico na América Latina Ricciardi, Guillermo Cirillo, Ignacio Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles Yurac, Ratko Ricciardi, Guillermo A. Cirillo Totera, Ignacio ¨Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles A. Yurac, Ratko Ricciardi, Guillermo Cirillo, Ignacio Pons Belmonte, Rodrigo Cabrera, Juan Pablo Guiroy, Alfredo Carazzo, Charles Yurac, Ratko spine multiple trauma thoracic vertebrae spinal cord injuries spine thoracolumbar trauma neurological damage columna vertebral traumatismo múltiplo vértebras torácicas traumatismos da medula espinal coluna vertebral traumatismo múltiplo vértebras torácicas traumatismos da medula espinal Introduction: Thoracolumbar fracture-dislocations from high-energy trauma are severe injuries requiring surgical stabilization. The risks faced by neurologically intact patients remain unclear. Objectives: To compare early complication rates in surgically treated patients with thoracolumbar fracture-dislocations according to neurological status. Methods: This 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. Results: A 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). Conclusions: Patients 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. Introducción: Las fracturas-luxaciones toracolumbares secundarias a traumatismos de alta energía constituyen lesiones graves que requieren estabilización quirúrgica. El riesgo de complicaciones en pacientes neurológicamente indemnes no se encuentra claramente establecido. Objetivos: Comparar las tasas de complicaciones tempranas en pacientes tratados quirúrgicamente por fracturas-luxaciones toracolumbares según el estado neurológico. Métodos: Se realizó un estudio de cohorte retrospectivo multicéntrico que incluyó pacientes de 24 instituciones de 9 países de América Latina sometidos a cirugía por fractura-luxación toracolumbar entre 2015 y 2023. Se incluyeron pacientes de ambos sexos, de 16 años o más, con traumatismos de alta energía que requirieron tratamiento quirúrgico. El desenlace primario fue la presencia de complicaciones postoperatorias tempranas, desde la admisión hasta el alta hospitalaria o el fallecimiento. Los pacientes se categorizaron según la presencia de compromiso neurológico al ingreso. Resultados: Se analizaron 262 pacientes, predominantemente hombres jóvenes (n = 212; 80,6%), con una edad media de 36,8 años (DE = 13,7). Las regiones torácica y toracolumbar fueron las más afectadas. Solo el 18% no presentó daño neurológico, y más de la mitad de los pacientes con déficit presentaron lesión medular completa. Se identificaron 268 complicaciones (mediana = 1; rango 0–9). Las complicaciones postoperatorias ocurrieron en el 28,6% de los pacientes sin compromiso neurológico y en el 74,3% de aquellos con compromiso neurológico (p < 0,001). La presencia de lesión neurológica se asoció fuertemente con la ocurrencia de complicaciones (OR = 7,4; IC 95%: 3,6–15,4; p < 0,001), al igual que la inestabilidad clínica (OR = 3,2; IC 95%: 1,6–6,4; p = 0,001). Conclusiones: Los pacientes con daño neurológico presentan un riesgo significativamente mayor de desarrollar complicaciones postoperatorias tempranas luego de la cirugía por fractura-luxación toracolumbar. Los resultados deben interpretarse considerando la limitada generalización derivada del muestreo institucional no probabilístico. Introdução: As fraturas-luxações toracolombares decorrentes de traumas de alta energia são lesões graves que requerem estabilização cirúrgica. Os riscos enfrentados por pacientes neurologicamente íntegros ainda não estão claramente definidos. Objetivos: Comparar as taxas de complicações precoces em pacientes submetidos a tratamento cirúrgico por fraturas-luxações toracolombares de acordo com o estado neurológico. Métodos: Estudo de coorte retrospectivo multicêntrico que incluiu pacientes de 24 instituições de 9 países da América Latina submetidos à cirurgia por fratura-luxação toracolombar entre 2015 e 2023. Foram incluídos pacientes de ambos os sexos, com idade ≥16 anos, vítimas de trauma de alta energia com indicação cirúrgica. O desfecho primário foi a ocorrência de complicações pós-operatórias precoces, desde a admissão até a alta hospitalar ou óbito. Os pacientes foram categorizados conforme a presença de lesão neurológica na admissão. Resultados: Foram analisados 262 pacientes, predominantemente homens jovens (n = 212; 80,6%), com idade média de 36,8 anos (DP = 13,7). As regiões torácica e toracolombar foram as mais acometidas. Apenas 18% não apresentaram lesão neurológica, e mais da metade dos pacientes com déficit apresentaram lesão medular completa. Foram identificadas 268 complicações (mediana = 1; intervalo 0–9). As complicações pós-operatórias ocorreram em 28,6% dos pacientes sem lesão neurológica e em 74,3% daqueles com lesão neurológica (p < 0,001). A lesão neurológica esteve fortemente associada à ocorrência de complicações (OR = 7,4; IC 95%: 3,6–15,4; p < 0,001), assim como a instabilidade clínica (OR = 3,2; IC 95%: 1,6–6,4; p = 0,001). Conclusões: Pacientes com lesão neurológica apresentam risco significativamente maior de complicações pós-operatórias precoces após cirurgia por fratura-luxação toracolombar. A generalização dos resultados é limitada pelo caráter não probabilístico da amostragem institucional. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2026-03-03 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/48345 10.31053/1853.0605.v83.n1.48345 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 83 No. 1 (2026): Avance de publicación; e48345 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 83 Núm. 1 (2026): Avance de publicación; e48345 Revista da Faculdade de Ciências Médicas de Córdoba; v. 83 n. 1 (2026): Avance de publicación; e48345 1853-0605 0014-6722 10.31053/1853.0605.v83.n1 eng https://revistas.unc.edu.ar/index.php/med/article/view/48345/52369 https://revistas.unc.edu.ar/index.php/med/article/view/48345/52394 Derechos de autor 2026 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |