Effects of thoracolumbar fracture combined with muscle injury on long-term outcome and prognosis: a retrospective study

To explore the relationship between muscle injury and severity, stability, and clinical outcomes in thoracolumbar fracture patients and identify prognostic factors. Clinical data from 118 thoracolumbar fracture patients (January 2017–December 2019) were retrospectively analyzed. Detailed information on patients’ clinical conditions, muscle injury degree, and spinal injuries was collected. Evaluation included TLICS, LSC, PLC, and IVD injury classifications, Denis grading, Sander grading, and preoperative load sharing score. Multifactor and correlation analyses identified factors influencing lumbar spine function and severe muscle injury. Muscle injury incidence post-thoracolumbar fracture was 83.05%, with moderate and severe injuries at 50.85%. At follow-up, kyphotic correction loss averaged 3.26 ± 1.83°, and ODI score after internal fixation was 14.78 ± 6.17. Muscle injury correlated positively with spinal fracture severity and stability. Significant associations were found between kyphotic correction loss and muscle injury in lumbar fractures. Multifactor analysis identified TLICS grading, PLC grading, and LSC score as key factors influencing ODI and severe muscle injury. This study addresses a knowledge gap on spinal fractures and associated muscle injuries, revealing a correlation between higher-grade spinal fractures and more severe muscle injury. Significantly, severe muscle injury was associated with greater kyphotic correction loss and worse mid- to long-term lumbar functional recovery.