Early perioperative outcomes after spinal cord injury due to low-energy fall: a retrospective comparative study of 78 patients with rigid versus 183 patients with nonrigid spine.

Authors

Alexander Zorzi, Andréane Richard-Denis, Manuel Jaramillo Jiménez, Jean-Marc Mac-Thiong

Published in

Journal of neurosurgery. Spine. Pages 1-9. Aug 07, 2026. Epub Aug 07, 2026.

Abstract

The number of patients with a rigid spine (e.g., due to ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis, or ossification of the posterior longitudinal ligament) requiring surgery after spinal cord injury (SCI) is rising. However, the impact of an underlying rigid spine on perioperative outcomes remains unclear. Therefore, the aim of this study was to compare the characteristics and perioperative outcomes of patients with rigid spine with that of patients without rigid spine after SCI due to a low-energy fall.
This retrospective analysis of prospectively collected data included a cohort of 261 adults who underwent surgery for acute SCI due to a low-energy fall at a single institution (April 2010-May 2024). Radiological studies were used to identify the presence or absence of an underlying rigid spine. Multivariable analysis was performed to determine associations between the presence of rigid spine and perioperative outcomes (neurological improvement, complications, and hospital length of stay [LOS]) while accounting for covariables.
Although the baseline SCI severity was similar, patients with rigid spine (n = 78) were older, had higher BMI, more comorbidities, and a longer surgery duration than those without rigid spine. In addition, patients with rigid spine had increased LOS (mean 39.2 ± 36.2 vs 26.4 ± 17.1, p = 0.004), rate of pneumonia (28.2% vs 13.7%, p = 0.005), and rate of urinary tract infection (30.8% vs 15.8%, p = 0.006). Multivariable analysis confirmed that having a rigid spine was associated with increased LOS and increased likelihood of pneumonia.
Following SCI due to a low-energy fall, patients with rigid spine had an increased hospital LOS and complication rate after surgery. Clinicians should rapidly identify the presence of rigid spine in patients after SCI, considering the higher risk of poor perioperative outcomes.

PMID:
42566789
Bibliographic data and abstract were imported from PubMed on 08 Aug 2026.

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