Notable Complications of Thoracic and Lumbar Spine Injury -High Risk Extension Injury

<p>Introduction: Although extension injuries are rare in traumatic thoracic and lumbar spine injuries and most of them are not accompanied by vascular injuries, severe complications such as vascular, esophageal, and ureteral injuries from extension injuries have been reported in diffuse idiopathic skeletal hyperostosis (DISH). Here, we investigated fracture-related risk factors for severe complications in thoracic and lumbar spine injuries.</p><p>Methods: Thoracic and lumbar spine injuries of the 210 vertebrae in 176 patients with AO-A3, 4, B, C, who underwent surgical treatment, were included. Severe complications were defined as injuries of the vessels or organs in the surrounding tissues of the fractured spine such as esophagus, thoracic duct, diaphragm, aorta, segmental artery, and ureter, and we divided all objects into the following two groups: group S (severe complication) and group N (no complication).</p><p>Results: There were 14 vertebrae of 14 cases in group S and 196 vertebrae of 162 cases in group N. Severe complications were segmental artery injury, thoracic duct injury, esophageal injury, ureteral injury, diaphragmatic hernia, and shifting embolization of aortic plaque. There were significant differences in age, AO classification, extension injury, and DISH between group S and N. Multiple logistic analyses using these factors as variables showed that extension injury was a risk factor for severe complications. There was also a significant difference in death within 1 month after surgery between both groups.</p><p>Conclusions: Extension injury in thoracic and lumbar spine was a high-risk factor of severe complications. Even in low-energy trauma, DISH spine extension injury was also a high risk of severe complications and should be notable.</p>