Time to Surgery for Unstable Thoracolumbar Fractures in Latin America—A Multicentric Study

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dc.contributor.authorGuiroy, Alfredo
dc.contributor.authorCarazzo, Charles
dc.contributor.authorZamorano, Juan
dc.contributor.authorCabrera, Juan
dc.contributor.authorJoaquim, Andrei
dc.contributor.authorGuasque, Joana
dc.contributor.authorSfredo, Ericson
dc.contributor.authorWhite, Kevin
dc.contributor.authorYurac, Ratko
dc.contributor.authorFalavigna, Asdrubal
dc.date.accessioned2022-04-05T22:18:45Z
dc.date.available2022-04-05T22:18:45Z
dc.date.issued2021
dc.description.abstractObjective We sought to identify delays for surgery to stabilize unstable thoracolumbar fractures and the main reasons for them across Latin America. Methods We reviewed the charts of 547 patients with type B or C thoracolumbar fractures from 21 spine centers across 9 Latin American countries. Data were collected on demographics, mechanism of trauma, time between hospital arrival and surgery, type of hospital (public vs. private), fracture classification, spinal level of injury, neurologic status (American Spinal Injury Association impairment scale), number of levels instrumented, and reason for delay between hospital arrival and surgical treatment. Results The sample included 403 men (73.6%) and 144 women (26.3%), with a mean age of 40.6 years. The main mechanism of trauma was falls (44.4%), followed by car accidents (24.5%). The most frequent pattern of injury was B2 injuries (46.6%), and the most affected level was T12-L1 (42.2%). Neurologic status at admission was 60.5% intact and 22.9% American Spinal Injury Association impairment scale A. The time from admission to surgery was >72 hours in over half the patients and over a week in >25% of them. The most commonly reported reasons for surgical delay were clinical instability (22.9%), lack of operating room availability (22.7%), and lack of hardware for spinal instrumentation (e.g., screws/rods) (18.8%). Conclusions Timing for surgery in this sample of unstable fractures was over 72 hours in more than half of the sample and longer than a week in about a quarter. The main reasons for this delay were clinical instability and lack of economic resources. There is an apparent need for increased funding for the treatment of spinal trauma patients in Latin America.es
dc.description.versionVersión publicadaes
dc.identifier.citationAlfredo Guiroy, Charles A. Carazzo, Juan J. Zamorano, Juan P. Cabrera, Andrei F. Joaquim, Joana Guasque, Ericson Sfredo, Kevin White, Ratko Yurac, Asdrubal Falavigna, Time to Surgery for Unstable Thoracolumbar Fractures in Latin America—A Multicentric Study, World Neurosurgery, Volume 148, 2021, Pages e488-e494, ISSN 1878-8750, https://doi.org/10.1016/j.wneu.2021.01.010.es
dc.identifier.urihttps://doi.org/10.1016/j.wneu.2021.01.010es
dc.identifier.urihttp://hdl.handle.net/11447/5942
dc.language.isoenes
dc.subjectEarly stabilizationes
dc.subjectLate stabilizationes
dc.subjectLumbar fracturees
dc.subjectSpinal cord injuryes
dc.subjectSpine surgeryes
dc.subjectThoracic fracturees
dc.subjectTiming of surgeryes
dc.titleTime to Surgery for Unstable Thoracolumbar Fractures in Latin America—A Multicentric Studyes
dc.typeArticlees
dcterms.sourceWorld Neurosurgeryes

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