Dimar et al identified risk factors for major complication following spinal stabilization of a thoracolumbar spinal injury. A patient with major complications tends to have a more prolonged and complex recovery. The authors are from multiple spine centers in the United States and Canada.


Early spinal stablization was performed < 72 hours after the injury.

Late spinal stabilization was performed > 72 hours after the injury.


The most common major complications were infections, thromboembolism and construct failure.


Risk factors for major complications:

(1) corticosteroid therapy

(2) Charlson comorbidity index (CCI)

(3) ASIA impairment scale


The risk for a major complication:

(1) increased with corticosteroid protocols (odds ratio of 2.3 vs no steroids)

(2) almost doubled for each unit increase in the CCI

(3) increased 2.5 times for each ASIA category


ASIA Category


E (normal)



2.5 times


5.0 times


7.5 times


10.0 times


To read more or access our algorithms and calculators, please log in or register.