Surgical versus non-surgical treatment for thoracolumbar burst fractures without neurological deficit

Management of burst fractures in the thoracolumbar spine

“…54,55 Patients with kyphosis >358 should be operated, and there are reports of progression causing chronic pain. 55,57 On the other hand, there have been differences in patients who had surgery had better recovery than those managed conservatively. Regarding pain, patients who had surgery had less need of pain medication compared to conservative treatment.…”

“…Regarding pain, patients who had surgery had less need of pain medication compared to conservative treatment. 16,28,17,32,35,55,57 …”

Cochrane in CORR ®: Surgical Versus Non-surgical Treatment for Thoracolumbar Burst Fractures Without Neurological Deficit

“…The authors performed a systematic review and meta-analysis of two randomized or quasi-randomized controlled trials (n = 87) comparing surgical with nonsurgical treatment [1]. Quasi-randomized trials use nonrandom methods of allocation such as alternation to assign participants to the comparison group.…”

“…Surgical stabilization and possible decompression may result in earlier mobilization, reduced time to hospital discharge, and faster return to work [9], but it may also expose patients to more-frequent early complications, an increased risk for subsequent revision surgery, and greater overall healthcare costs [9]. Nonoperative management including symptomatic pain control, early mobilization, and perhaps a brace may be an acceptable alternative in properly selected patients [1]. This Cochrane systematic review compared surgical versus non-surgical treatment for thoracolumbar burst fractures in patients without neurological deficits.…”

Posterior Fixation with Unilateral Same Segment Pedicle Fixation and Contralateral Hook in Surgical Treatment of Thoracolumbar Burst Fractures

“…Although some authors believe that in more stable thoracolumbar burst fractures associated with normal neurologic examination, nonoperative treatment provided the same long-term advantages as surgery, in the patients with more severe injuries and neurologic deficit, early fusion and instrumentation can promote earlier mobilization and neurologic rehabilitation [4][5][6][7]. In spinal surgery of lumbar area, literature reveals that spondylodesis of the freely moving lumbar vertebrae is strongly correlated with functional disability in activities of daily living [8].…”