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

Aleem, Ilyas; Nassr, Ahmad

doi:10.1007/s11999-015-4305-y

Cited by 11 publications

(6 citation statements)

References 15 publications

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“…Several published studies have compared the conservative and surgical treatment of BFs without neurological deficit; nevertheless, the decision to operate or not remains controversial, in as much as, overall, both approaches have shown comparable outcomes 11,[24][25][26] . It is worth restating that a greater age and interpedicular distance seem to be predictors of failure of conservative treatment 15 .…”

Section: Discussionmentioning

confidence: 99%

Thoracolumbar Burst Fractures: A Systematic Review and Meta-Analysis on the Anterior and Posterior Approaches

Roblesgil‐Medrano

Tellez-Garcia

Bueno-Gutierrez

et al. 2022

Spine Surg Relat Res

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ARM designed the study, conducted statistical analyses, wrote and edited this article. ETG gathered data, conducted data analysis, and interpreted and edited this article. LCBG participated in the study design and contributed extensively to the editing and writing of this article. BVE and JRRB gathered data. CAGG participated in study conceptualization, design, analysis, and editing. EFV and JAFS participated in study conceptualization, design, gathering of data, and editing. DEHG designed the study, conducted statistical analyses, and wrote this article.

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Section: Discussionmentioning

confidence: 99%

Thoracolumbar Burst Fractures: A Systematic Review and Meta-Analysis on the Anterior and Posterior Approaches

Roblesgil‐Medrano

Tellez-Garcia

Bueno-Gutierrez

et al. 2022

Spine Surg Relat Res

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“…Approximately 60–70% of all traumatic spinal fractures are thoracolumbar fractures (TLFs, from T11 to L2), which is ascribed to the special biomechanical characteristics of the thoracolumbar spine that translate from the rigid, kyphotic thoracic spine to the mobile, lordotic lumbar spine [ 2 ]. Surgical or conservative management of TLFs remains controversial, especially for patients without neurological deficits [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of monoplanar and polyaxial screw fixation systems in percutaneous intermediate fixation for thoracolumbar fractures

Huang¹,

Xiong²,

Guo³

et al. 2022

BMC Musculoskelet Disord

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Background The newly developed monoplanar pedicle screws (MPPSs) can mobile in axial plane but fixed in the sagittal plane, which holds potential to combine ease of rod placement with sagittal plane strength theoretically. So far, few clinical studies focused on the outcomes of MPPSs for treatment of thoracolumbar fractures (TLFs). The aim of this study was to compare the efficacy of MPPSs to polyaxial pedicle screws (PAPSs) in percutaneous intermediate fixation of TLFs. Methods Seventy-eight patients who sustained TLFs without neurological deficits and underwent percutaneous intermediate fixation using MPPSs (40 patients) or PAPSs (38 patients) with a minimum 1-year follow-up were included in this study. The operation time, blood loss, local Cobb angle (LCA), vertebral wedge angle (VWA), anterior body height ratio (ABHR), visual analogue scale (VAS) and Oswestry Disability Index (ODI) were collected. Results No significant differences were observed in baseline demographics, clinical characteristics, operation time or blood loss between the two groups (P > 0.05). The postoperative LCA, VWA and ABHR were significantly corrected compared to these parameters preoperatively in both groups (#P < 0.05). The postoperative LCA, VWA and ABHR in the MPPS group were significantly better corrected than those in the PAPS group (*P < 0.05). Furthermore, the correction loss of LCA, VWA and ABHR in the MPPS group was significantly lower than that in the PAPS group (*P < 0.05). However, no significant difference in VAS and ODI scores was observed between the two groups. Conclusions MPPSs showed similar efficiency as PAPSs in percutaneous intermediate fixation surgical procedures. More importantly, MPPSs achieved better radiological performance than PAPSs in the correction of TLFs and the prevention of correction loss.

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“…Many attempts have been made to classify thoracolumbar burst fractures to guide management [6][7][8][9][10] . Treatment courses are primarily divided into surgical and conservative interventions, both of which aim to provide mechanical and neurological stability, early mobilization, pain control, and avoidance of complications 11,12 . In the narrowest terms, thoracolumbar spinal trauma cases can be simplified into those in patients who are neurologically intact and those in patients who are not neurologically intact.…”

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confidence: 99%

Effects of Bracing on Clinical and Radiographic Outcomes Following Thoracolumbar Burst Fractures in Neurologically Intact Patients

Wallace¹,

McHugh²,

Patel³

et al. 2019

JBJS Rev

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Background: We conducted a meta-analysis of randomized trials to determine the effect of the use of an orthosis (as compared with no orthosis) on clinical and radiographic outcomes in neurologically intact patients with thoracolumbar burst fractures. Optimal nonoperative treatment of thoracolumbar burst fractures in neurologically intact patients remains inconclusive. Conventional care prescribes spine precautions and a thoracolumbar orthosis. Recent studies have suggested that patients with stable burst fractures can obtain comparable outcomes with or without bracing.Methods: We performed a comprehensive search of the literature with use of OVID MEDLINE, Embase, and the Cochrane Library. Two independent reviewers assessed the eligibility of studies and the risk of bias of included trials. We analyzed several outcomes: the Roland Morris Disability Questionnaire (RMDQ) score, Oswestry Disability Index (ODI), Short Form-36 Physical and Mental Component Summary (SF-36 PCS and MCS) scores, pain, length of stay, treatment failure, and kyphotic angle. We used weighted mean differences and standardized mean differences in a random-effects model. Results:We included 3 studies with a total of 59 patients who were managed with use of a brace and 60 patients who were managed without a brace. There was no significant difference between groups treated with or without an orthosis in terms of SF-36 PCS, SF-36 MCS, RMDQ/ODI, pain, length of stay, failure rates, or kyphosis angle at baseline or 6-month follow-up. Similar outcomes were seen at longterm follow-up of $5 years.Conclusions: This meta-analysis suggests that neurologically intact patients with thoracolumbar burst fractures obtain similar clinical and radiographic outcomes with or without bracing at both short and long-term follow-up. Routine use of orthoses following these fractures may incur substantial costs and patient morbidity without clinical benefit.

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

Cited by 11 publications

References 15 publications

Thoracolumbar Burst Fractures: A Systematic Review and Meta-Analysis on the Anterior and Posterior Approaches

Thoracolumbar Burst Fractures: A Systematic Review and Meta-Analysis on the Anterior and Posterior Approaches

Comparison of monoplanar and polyaxial screw fixation systems in percutaneous intermediate fixation for thoracolumbar fractures

Effects of Bracing on Clinical and Radiographic Outcomes Following Thoracolumbar Burst Fractures in Neurologically Intact Patients

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