Treatment of traumatic thoracolumbar spine fractures: a multicenter prospective randomized study of operative versus nonsurgical treatment.
METHODS
Multicenter prospective randomized trial.


OBJECTIVE
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.


BACKGROUND
There are various opinions regarding the ideal management of thoracolumbar Type A spine fractures without neurologic deficit. Both operative and nonsurgical approaches are advocated.


METHODS
Patients were randomized for operative or nonsurgical treatment. Data sampling involved demographics, fracture classifications, radiographic evaluation, and functional outcome.


RESULTS
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.


CONCLUSIONS
Patients with a Type A3 thoracolumbar spine fracture without neurologic deficit should be treated by short-segment posterior stabilization.
Siebenga
Jan
J
Atrium Medisch Centrum Parkstad, Postbus 4446, 6401 CX Heerlen, The Netherlands. jan@siebenga.speedxs.nl
Leferink
Vincent J M
VJ
Segers
Michiel J M
MJ
Elzinga
Matthijs J
MJ
Bakker
Fred C
FC
Haarman
Henk J Th M
HJ
Rommens
Pol M
PM
ten Duis
Henk-Jan
HJ
Patka
Peter
P
D000293:Adolescent; D000328:Adult; D001915:Braces; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D016103:Spinal Fractures / Q000453:epidemiology / Q000534:rehabilitation* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*