title: Timing of Surgery for Spinal Fractures Associated with Systemic Trauma: A Need for a Strategic and Systemic Approach.
abstract: OBJECTIVE
  An underestimated evaluation of systemic organs in cases with spinal fractures might jeopardize the intervention for treatment and future complications with an increased morbidity and mortality are almost warranted. In the present study, a retrospective analysis of spinal fracture cases associated with systemic trauma was performed to assess surgical success.
  
  
  METHODS
  A retrospective analysis of patients with thoracolumbar fractures who were admitted to the emergency unit between September 2012 and September 2014 was used for the study. The cases were categorized according to age, sex, reason of trauma, associated trauma, neurological condition and treatment details and results were analysed using SPSS 14.0 for Windows.
  
  
  RESULTS
  The most common reason of trauma is detected as falls in 101 cases (64.3%). Radiological evaluation of spinal fractures revealed a compression fracture in 106 cases (67.5%) and other fractures in 51 cases (32.5%). Surgical treatment for spinal fracture was performed in 60.5% of the cases and conservative approach was preferred in 39.5% cases. In non-compressive spinal fractures, an associated pathology like head trauma, lower extremity fracture or neurological deficit was found to be higher in incidence (p < 0.05). Necessity for surgical intervention was found to be more prominent in this group (p < 0.05). However, the fracture type was not found to be associated with morbidity and mortality (p < 0.05).
  
  
  CONCLUSIONS
  A surgical intervention for a spinal fracture necessitating surgery should rather be performed right after stabilization of the systemic condition which might be associated with decreased morbidity and mortality.
authors.affiliation: Yenimahalle State Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
authors.forename: Ismet
authors.initials: I
authors.lastname: Koksal
authors.forename: Fatih
authors.initials: F
authors.lastname: Alagoz
authors.forename: Haydar
authors.initials: H
authors.lastname: Celik
authors.forename: Ali Erdem
authors.initials: AE
authors.lastname: Yildirim
authors.forename: Tezcan
authors.initials: T
authors.lastname: Akin
authors.forename: Yahya
authors.initials: Y
authors.lastname: Guvenc
authors.forename: Mete
authors.initials: M
authors.lastname: Karatay
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Erdem
mesh_terms: D000328:Adult; D000368:Aged; D006259:Craniocerebral Trauma / Q000150:complications / Q000601:surgery; D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D019637:Orthopedic Procedures / Q000379:methods*; D010347:Patient Care Planning; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000601:surgery; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications / Q000601:surgery*