{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:25:12Z","timestamp":1784762712459,"version":"3.55.0"},"reference-count":98,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:p>The understanding of the optimal surgical timing for stabilization in thoracolumbar fractures is severely limited. Thoracolumbar spine fractures can be devastating injuries and are often associated with significant morbidity and mortality. The role of early surgical stabilization (within 48\u201372 hours of injury) as a vehicle to improve outcomes in these patients has generated significant interest. Goals of early stabilization include improved neurological recovery, faster pulmonary recovery, improved pain control, and decreased health care costs. Opponents cite the potential for increased bleeding, hypotension, and the risk of further cord injury as a few factors that weigh against early stabilization. The concept of spinal cord injury and its relationship to surgical timing remains in question. However, when neurological outcomes are eliminated from the equation, certain measures have shown positive influences from prompt surgical fixation.<\/jats:p>\n                  <jats:p>Early fixation of thoracolumbar spine fractures can significantly decrease the duration of hospital stay and the number of days in the intensive care unit. Additionally, prompt stabilization can reduce rates of pulmonary complications. This includes decreased rates of pneumonia and fewer days on ventilator support. Cost analysis revealed as much as $80,000 in savings per patient with early stabilization. All of these benefits come without an increase in morbidity or evidence of increased mortality. In addition, there is no evidence that early stabilization has any ill effect on the injured or uninjured spinal cord. Based on the existing data, early fixation of thoracolumbar fractures has been linked with positive outcomes without clear evidence of negative impacts on the patient's neurological status, associated morbidities, or mortality. These procedures can be viewed as \u201cdamage control\u201d and may consist of simple posterior instrumentation or open reductions with internal fixation as indicated. Based on the current literature it is advisable to proceed with early surgical stabilization of thoracolumbar fractures in a well-resuscitated patient, unless extenuating medical conditions would prevent it.<\/jats:p>","DOI":"10.3171\/2014.5.focus1473","type":"journal-article","created":{"date-parts":[[2014,7,1]],"date-time":"2014-07-01T11:06:02Z","timestamp":1404212762000},"page":"E7","source":"Crossref","is-referenced-by-count":37,"title":["Timing of surgery in thoracolumbar trauma: is early intervention safe?"],"prefix":"10.3171","volume":"37","author":[{"given":"Christopher Paul","family":"O'Boynick","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Saint Louis University, St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark F.","family":"Kurd","sequence":"additional","affiliation":[{"name":"OrthoCarolina Spine Center, Orthopaedic Surgery, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce V.","family":"Darden","sequence":"additional","affiliation":[{"name":"OrthoCarolina Spine Center, Orthopaedic Surgery, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Hospital, Rothman Institute, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"9 Suppl","key":"b1-focus1473","series-title":"Spine (Phila Pa 1976)","first-page":"S138","article-title":"Does early fracture fixation of thoracolumbar spine fractures decrease morbidity or mortality?","volume":"35","author":"Bellabarba","year":"2010"},{"issue":"3 Suppl","key":"b2-focus1473","series-title":"Neurosurgery","first-page":"S58","volume":"50","year":"2002"},{"key":"b3-focus1473","series-title":"J Neurotrauma","first-page":"2220","article-title":"Retrospective, propensity score-matched cohort study examining timing of fracture fixation for traumatic thoracolumbar fractures","volume":"29","author":"Boakye","year":"2012"},{"key":"b4-focus1473","series-title":"J Bone Joint Surg Br","first-page":"165","article-title":"The place of closed manipulation in the management of flexion-rotation dislocations of the cervical spine","volume":"53","author":"Burke","year":"1971"},{"key":"b5-focus1473","series-title":"J Bone Joint Surg Am","first-page":"86","article-title":"Sustained spinal cord compression: part I: time-dependent effect on long-term pathophysiology","volume":"85-A","author":"Carlson","year":"2003"},{"key":"b6-focus1473","series-title":"Spine (Phila Pa 1976)","first-page":"E727","article-title":"Early versus late stabilization of spine injuries: a systematic review","volume":"36","author":"Carreon","year":"2011"},{"key":"b7-focus1473","series-title":"Arch Orthop Trauma Surg","first-page":"959","article-title":"Timing of thoracolomber spine stabilization in trauma patients; impact on neurological outcome and clinical course. 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