Treatment of Traumatic Thoracolumbar Spine Fractures: A Multicenter Prospective Randomized Study of Operative Versus Nonsurgical Treatment
- 1 December 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Spine
- Vol. 31 (25), 2881-2890
- https://doi.org/10.1097/01.brs.0000247804.91869.1e
Abstract
Multicenter prospective randomized trial.To test the hypotheses that thoracolumbar AO Type A spine fractures without neurologic deficit, managed with short-segment posterior stabilization will show an improved radiographic outcome and at least the same functional outcome as compared with nonsurgically treated thoracolumbar fractures.There are various opinions regarding the ideal management of thoracolumbar Type A spine fractures without neurologic deficit. Both operative and nonsurgical approaches are advocated.Patients were randomized for operative or nonsurgical treatment. Data sampling involved demographics, fracture classifications, radiographic evaluation, and functional outcome.Sixteen patients received nonsurgical therapy, and 18 received surgical treatment. Follow-up was completed for 32 (94%) of the patients after a mean of 4.3 years. At the end of follow-up, both local and regional kyphotic deformity was significantly less in the operatively treated group. All functional outcome scores (VAS Pain, VAS Spine Score, and RMDQ-24) showed significantly better results in the operative group. The percentage of patients returning to their original jobs was found to be significantly higher in the operative treated group.Patients with a Type A3 thoracolumbar spine fracture without neurologic deficit should be treated by short-segment posterior stabilization.Keywords
This publication has 69 references indexed in Scilit:
- Successful Short-Segment Instrumentation and Fusion for Thoracolumbar Spine FracturesSpine, 2000
- Selection criteria and outcome of operative approaches for thoracolumbar burst fractures with and without neurological deficitJournal of Neurosurgery, 1997
- Surgical approaches for the correction of unstable thoracolumbar burst fractures: a retrospective analysis of treatment outcomesJournal of Neurosurgery, 1995
- A comprehensive classification of thoracic and lumbar injuriesEuropean Spine Journal, 1994
- Results of the AO spinal internal fixator in the surgical treatment of thoracolumbar burst fracturesEuropean Spine Journal, 1994
- Operative Treatment of Spinal Fractures with the AO Internal FixatorSpine, 1991
- Evaluation of Surgical Treatment for Burst FracturesSpine, 1990
- Unstable Thoracolumbar FracturesActa Radiologica. Diagnosis, 1985
- Harrington instrumentation as a method of fixation in fractures of the spineThe Journal of Bone and Joint Surgery. British volume, 1982
- Treatment of Patients with Unstable Fractures of the Thoracic and Lumbar Spine:A Follow-up Study of Surgical and Conservative TreatmentActa Orthopaedica, 1982