{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T20:12:27Z","timestamp":1789157547125,"version":"build-2803163510"},"reference-count":12,"publisher":"ALUNA","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:p>Aim: To conduct a forensic medical evaluation of the severity of bodily injuries in thoracic and lumbar traumatic spinal cord injury; to assess surgical care quality indicators in percutaneous and open transpedicular fixation in the context of iatrogenic risk and prevention of medical care deficiencies; to analyse whether the surgical stabilisation method may influence parameters of forensic significance for evaluating injury outcomes.\nMaterials and Methods: A retrospective study of 269 patients: open fixation (215), percutaneous fluoroscopy-guided fixation (54). Assessed: Frankel scale, pelvic dysfunction, blood loss, duration of surgery and anesthesia, fentanyl dose, hyperthermia, and implant quality.\nResults: Severe bodily injury (life-threatening) was established in 27.9% (Group 1) vs 7.4% (Group 2) (p=0.001); by \u226533% permanent disability \u2013 22.3% vs 7.4% (p=0.012). Mean permanent disability: 30.1\u00b124.2% vs 17.8\u00b17.9% (p&lt;0.001). Neurological deficit (Frankel A-D) at admission: 32.4% vs 7.7%. Moderate injuries: 63.3% vs 88.9%; no mild injuries. Percutaneous technique resulted in 16.3-fold lower blood loss (20 vs 325 mL; p&lt;0.001), lower fentanyl dose, and shorter anesthesia (p&lt;0.001); implant quality did not differ (p&gt;0.05).\nConclusions: Injury severity is a fixed legal fact determined by the primary trauma. Surgery may affect legal qualification via: change in outcome at reassessment; qualification of care defects as independent injuries. Percutaneous fixation significantly reduces iatrogenic risk. Documentation gaps complicate forensic evaluation of care quality.<\/jats:p>","DOI":"10.36740\/merkur202604112","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:56:49Z","timestamp":1789156609000},"page":"458","source":"Crossref","is-referenced-by-count":0,"title":["Forensic medical assessment of thoracic and lumbar traumatic spinal cord injury in percutaneous and open transpedicular fixation"],"prefix":"10.36740","volume":"54","author":[{"given":"Ivan V.","family":"Varnakov","sequence":"first","affiliation":[{"name":"BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE; MUNICIPAL NON-PROFIT ENTERPRISE KYIV CITY CLINICAL EMERGENCY HOSPITAL, KYIV, UKRAINE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volodymyr V.","family":"Medvediev","sequence":"additional","affiliation":[{"name":"BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina O.","family":"Pletenetska","sequence":"additional","affiliation":[{"name":"BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22436","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref0","unstructured":"1. 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