Abstract text (incl. references and figure legends)
The combination of polytrauma and spine injury is important due to the high incidence of complications and secondary neurological deterioration. The complex and not standardized approach of this group of injured patients with a wide spectrum of injuries makes it difficult to treat. DCO is a good strategy for the treatment of polytrauma patients but unfortunately is not often available for these patients with a thoracolumbar spine injury. By expanding the time limit; following the trend of occult peripheral hypoperfusion; specifically analyzing individually associated injuries, and individualizing the treatment "tailored" to each patient, according to the Safe Definitive Surgery Strategy, we have achieved better results in treating this group of pt.
We have collected retrospectively and analyzed data from all polytrauma patients that involve thoracolumbar fractures from 2015 – 2020. 83 patients met the inclusion criteria of ISS>15, age 16-70. Early intervention (<48h) has been performed on 32 patients. The posterior transpedicular fixation, with or without laminectomy has been done in all patients. Anterior decompression and stabilization were used on several patients, after the resolution of associated injuries. The late intervention has been performed on the rest of the pt.
We compared the mortality, neurological recovery, length of hospital stay, and length of ICU stay between the early and late intervention groups. The mean follow-up was 16 months. Mortality was lower in the Early intervention group (EIG). The Length of hospital stay and ICU stay is obviously shorter on the EIG. The pressure sores and respiratory support are also lower in the EIG.
Early intervention is a safe and preferred treatment strategy for the treatment of polytraumatized patients with spine injuries. The patient-tailored treatment, considering all the factors of the personality of the injury, seems to be the best treatment strategy for this group of patients.
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no confict of interest.