P150. Early surgery for thoracolumbar extension type fractures in geriatric patients with spinal ankylosing disorders is Associated with decreased perioperative patient complications

BACKGROUND CONTEXT The treatment of patients with spinal ankylosing disorders (SAD) continues to pose a unique challenge for the practitioner. This population is especially susceptible to vertebral column fractures, specifically unstable extension type fractures even from minor trauma. An increase in geriatric patients with unstable extension type vertebral fractures may be especially anticipated due to change in patient demographics including an increase in age and prevalence of associated comorbidities. In the geriatric population, studies have shown that early surgery for other injuries such as hip fractures may reduce patient complications and mortality. These studies have changed patient care protocols in many medical centers worldwide. PURPOSE In this study, we aim to assess the relationship between the timing of surgery for vertebral fractures in this population and patient complications, rehospitalization rates, length of hospital stays and mortality. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE Patients included were those diagnosed with thoracolumbar extension type fractures and a SAD, over 65 years old, following minor trauma and with no prior spinal instrumentation. OUTCOME MEASURES Patient complications, surgical site infections, rehospitalization rates, length of hospital stays and perioperative mortality. METHODS We searched our department's database for all patients that met our inclusion criteria. Difference in patient outcomes that underwent early surgery of less than 72 hours from diagnosis as opposed to those that underwent later surgery was assessed. RESULTS A total of 85 patients were diagnosed with extension type thoracolumbar fractures at our institution between 2016-2020. Of these, 47 met the inclusion criteria for this study. Nineteen patients underwent surgery less than 72 hours from diagnosis and 28 more than 72 hours from diagnosis. No difference was found in age and Elixhauser comorbidity scores between the groups. A statistically significant difference in perioperative patient complications between the early and the late groups (p=0.0003) was found. There was no statistically significant difference between the groups when comparing surgical site infections, length of hospital stay, rehospitalization within a month and perioperative mortality. CONCLUSIONS Time to surgery may affect complication rates in patients of the elderly population with spinal ankylosing disorders presenting with unstable hyperextension type thoracolumbar fractures. Early surgery in this patient population should be considered. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.