Analysis of the efficacy of surgical treatment for spinal injuries in polytrauma patients

SUN Xiang-yao; WANG Wei-liang; GAN Li-meng; CAO Li; WANG Ju-yong; HUANG Jiang; LIU Yu-qi; LU Shi-bao

doi:10.3969/j.issn.2095-252X.2025.04.003

Abstract：Objective To determine the epidemiology,clinical status,and surgical trends in polytrauma patients with spinal injuries,and to assess short-term treatment outcomes along with their influencing factors.Methods This retrospective study analyzed polytrauma patients who underwent spinal surgery in Beijing Daxing District People's Hospital from January 2017 to January 2023.A total of 60 patients were included.Neurological impairment was assessed using the American Spinal Injury Association(ASIA)score,while the patients'mental status upon admission was evaluated using the Glasgow Coma Scale(GCS).Additional spinal injuries were assessed based on the abbreviated injury scale(AIS).Surgical data included the number and type of spinal surgeries performed,as well as the time from admission to surgery.Imaging parameters included the Cobb angle of the injured segment.Follow-up data included neurological function,occurrence of complications,length of stay in the intensive care unit,and total length of hospitalization.Results Patients involved in road traffic accidents were younger(46.9±16.2)years compared to those not involved(57.6±19.5)years,P=0.024.In terms of the Injury Severity Score(ISS),there were significant statistical differences between patients with ASIA grade C or lower(ISS 44.9±14.3)and those with ASIA grade D or E(ISS 34.0±11.6)(P=0.002).There was no significant statistical difference in ISS between patients with multiple spinal injuries(37.6±11.8)and those with single spinal injuries(40.1±15.7)(P=0.495).There was no significant correlation between the number of spinal injuries and ISS(P=0.135).Except for lumbar spine injuries(P=0.013),there was no significant difference between patients with and without neurological impairment when the injury site was in the cervical spine(P=0.175)or thoracic spine(P=0.099).Postoperatively,all cases showed significant reduction of vertebral posterior wall,with an average reduction angle of(14.6±5.7)°(P=0.013).Conclusions The overall severity of multiple spinal injuries is significantly influenced by the neurological functional status.There is a significant difference in the number of associated injuries between patients with and without neurological impairment.However,there is no significant difference in the severity of neurological impairment among patients with different numbers of spinal injuries within the group of patients with neurological damage.