title: Neurological outcome in a series of 58 patients operated for traumatic thoracolumbar spinal cord injuries.
abstract: BACKGROUND
  Traumatic thoracolumbar spinal fractures represent approximately 65% of all traumatic spinal fractures and are frequently associated to permanent disability with significant social and economic impact. These injuries create severe physical limitations depending on neurological status, level of fracture, severity of injury, patient age and comorbidities. Predicting neurological improvement in patients with traumatic spinal cord injuries (SCIs) is very difficult because it is related to different preoperative prognostic factors. We evaluated the neurological improvement related to the preoperative neurological conditions and the anatomic level of spinal cord injury.
  
  
  METHODS
  From January 2004 to June 2010, we operated 207 patients for unstable thoracolumbar spinal fractures. We carried out a retrospective analysis of 69 patients with traumatic SCIs operated on by a posterior fixation performed within 24 hours from the trauma. The preoperative neurological conditions (ASIA grade), the type of the fracture, the anatomic level of spinal cord injury and the postoperative neurological improvement were evaluated for each patient.
  
  
  RESULTS
  The ASIA grade at admission (P = 0,0005), the fracture type according to the AO spine classification (P = 0,0002), and the anatomic location of the injury (P = 0,0213) represented predictive factors of neurological improvement at univariate analysis. The preoperative neurological status (P = 0,0491) and the fracture type (P = 0,049) confirmed a positive predictive value also in the multivariate analysis.
  
  
  CONCLUSIONS
  Our study confirms that the preoperative neurological status, the fracture type and the anatomic location of the fracture are predictive factors of the neurological outcome in patients with spinal cord injury.
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Dobran
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Iacoangeli
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Lucia Giovanna Maria
authors.initials: LG
authors.lastname: Di Somma
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Rienzo
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Colasanti
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Nocchi
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Alvaro
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Moriconi
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Nasi
authors.affiliation: Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Scerrati
keywords: Neurologic recovery; pedicle screw fixation; spinal cord injury; thoracic spine fractures; thoracolumbar fractures