Abstract
<title>Abstract</title> <p>Objective: The aims of this study were to evaluate the outcomes of surgical treatment for pediatric patients with burst fractures combined with neurological impairment, and to determine whether surgical intervention can lead to improved functional outcomes, thereby analyzing the safety and efficacy of spinal surgery in children. Methods: Patients who underwent surgery for one or more vertebral fractures of the thoraco-lumbar spine at the Children's Medical Center between 2018 and 2022 were recruited. For each patient, type of trauma and fractured vertebral levels were recorded, and the neurological status was evaluated by American spinal injury association (ASIA) classification. Treatment outcomes included the local kyphotic angle (LKA), the percentage of loss of vertebral body height (LOVBH), the spine canal compromise (SCC) and Japanese Orthopedic Association Scores (JOA). Results: All patients were followed up for(48±2.1）months. The results demonstrated significant improvements in several key outcomes following treatment for thoracolumbar burst fractures. Notably, LKA , LOVBH and SCC were significantly improved after treatment in patients with thoracolumbar burst fractures (all P < 0.05). In addition, patients demonstrated good recovery in their functional abilities, as indicated by significant improvements in the JOA scores (t=-7.85 , P < 0.05). Conclusion: Surgical management is often recommended for unstable spinal fractures and those that lead to a neurological deficit.The application of instrumentation at the injury level demonstrates efficacy in addressing injury-induced LKA, LOVBH, and SCC changes in adolescents, with patients exhibiting favorable functional recovery outcomes. Key Words: Thoracolumbar spine fracture, Adolescents, Operative treatment</p>