Short-segment posterior fixation provides partial kyphosis correction and earlier pain relief, but the functional outcome at 2 years is similar. Early activity to the point of pain tolerance can be safely allowed.
Despite the use of less restrictive criteria, no brace, and early activity as tolerated, the results are similar to those obtained with more restrictive protocols. The presence of vertical lamina fracture, spinous process fracture, and transverse process fracture are not contra--indications. Activity restriction and bracing may be important for pain control but probably does not change the long-term result.
The timing and pattern of radial nerve recovery in this situation was similar to that seen in primary radial nerve palsy. There appears to be no advantage to early exploration of the radial nerve. In the absence of obviously misplaced instrumentation or fracture displacement, we treat it like a primary palsy and recommend observation for a minimum of 4 months before exploration.
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