Effect of different spinal segment injuries on postoperative recovery of patients with thoracolumbar fractures and analysis of risk factors

Objectives Understanding the segment-specific characteristics of thoracolumbar junction injuries and their impact on postoperative rehabilitation is crucial for developing precision therapeutic strategies. However, current evidence remains insufficient in elucidating the relationship between fracture levels and key recovery metrics. This study aims to investigate the correlation between injury segments and postoperative functional outcomes in thoracolumbar fracture patients and provide an evidence-based framework for optimizing segment-specific rehabilitation protocols and enhancing postoperative recovery efficacy. Methods Patients with thoracolumbar fractures (n = 636) were stratified into three cohorts based on anatomical injury levels: T11-T12 group, T12-L1 group, and L1-L2 group. Comprehensive data collection encompassed demographic characteristics, injury profiles, and postoperative recovery metrics. Statistical analyses comprised one-way ANOVA for continuous variables, chi-square tests for categorical comparisons, and binary logistic regression modeling to elucidate intervariable relationships. Results Multivariate regression analysis identified fracture level, gender, injury season, preoperative Frankel grade, postoperative ambulation recovery time, and walking distance as critical determinants of personal daily living ability. After controlling for confounding variables, the fracture level remained an independent predictor of functional recovery (p < 0.01). Notably, comparative analysis revealed significantly impaired recovery of personal daily living ability in both the T12-L1(OR = 4.331, 95% CI: 1.871–10.025, p = 0.001) and L1-L2 group (OR = 3.306, 95% CI: 1.357–6.794, p = 0.007) relative to the T11-T12 group. Conclusions Patients with thoracolumbar fractures at T12-L1 and L1-L2 segments demonstrated suboptimal recovery in personal daily living ability during postoperative rehabilitation, necessitating enhanced clinical surveillance and targeted intervention strategies.