Effectiveness and postoperative rehabilitation of one-stage combined anterior-posterior surgery for severe thoracolumbar fractures with spinal cord injury

World Journal of Clinical Cases, 2022 · DOI: 10.12998/wjcc.v10.i18.6001 · Published: June 26, 2022

Simple Explanation

This study investigates a surgical approach for severe spinal fractures combined with spinal cord injury, comparing one-stage combined anterior-posterior surgery to one-stage anterior-approach surgery. The goal was to evaluate the effectiveness and rehabilitation outcomes of the combined approach in improving function and quality of life for patients. The study found that while the combined approach had some drawbacks like longer operation time, it led to better vertebral height restoration and improved quality of life compared to the anterior approach alone.

Study Duration

February 2018 to February 2020

Participants

120 patients with severe thoracolumbar fractures and spinal cord injury

Evidence Level

Case Control Study

Key Findings

1
Blood loss and operation time were significantly greater in the combined anterior-posterior surgery group compared to the anterior-approach surgery group.
2
The anterior and posterior vertebral height ratios were significantly higher in the combined surgery group after surgery, indicating better vertebral restoration.
3
Quality of life scores were markedly better in the combined surgery group after surgery, suggesting improved overall well-being.

Research Summary

The study compared one-stage combined anterior-posterior surgery with one-stage anterior-approach surgery for severe thoracolumbar fractures with spinal cord injury. The combined approach led to greater blood loss and longer operation times but resulted in better restoration of vertebral height and improved quality of life. The authors conclude that the one-stage combined anterior-posterior surgery is an effective approach worthy of promotion in clinical use for these types of fractures.

Practical Implications

Clinical Practice

The one-stage combined anterior-posterior surgery can be considered as a valuable option for treating severe thoracolumbar fractures with spinal cord injury, particularly where restoration of vertebral height and improved quality of life are prioritized.

Surgical Planning

Surgeons should be aware of the potential for greater blood loss and longer operation times with the combined approach and plan accordingly.

Patient Education

Patients should be informed about the potential benefits and risks of both surgical approaches to allow for shared decision-making.

Study Limitations

1
Single-center study with a limited number of patients.
2
Short follow-up period, limiting the assessment of long-term efficacy.
3
The novel surgical approach needs to be attempted in more centers to validate the findings.

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