title: Clinical and radiological outcomes of conservative treatment after stable post-traumatic thoracolumbar fractures in elderly: Is it really best option for all elderly patients?
abstract: OBJECTIVE
  The purpose of this study was to research the effectiveness of conservative treatment of stable post-traumatic thoracolumbar vertebral fractures in elderly patients.
  
  
  METHODS
  The study included 21 elderly patients (13 females, 8 males) with post-traumatic thoracolumbar compression fracture who were treated with a brace. Fractures without any trauma history, pathological fractures, patients younger than 60 years old and patients with no malignancy history were excluded from study. Neurological examination and posterior ligamentous complex (PLC) were intact in all patients. Radiological parameters and pain scores were recorded in regular follow-up.
  
  
  RESULTS
  The mean age and follow-up were 71.3 years (range, 60-84 years) and 20.1 months (range, 12-26 months) respectively. During follow-up, 4 patients had significant height loss resulting in kyphotic deformity and intractable pain. There was a significant increase in the local kyphosis angle (p = 0.001) and height loss percentage (p = 0.017). At the final follow-up, the mean Denis Score of pain was 1.62 ± 0.74.
  
  
  CONCLUSIONS
  Although there is wide acceptance of conservative treatment of post-traumatic stable thoracolumbar fracture with intact PCL according to the Thoracolumbar Injury Classification and Severity Score (TLICS), elderly female patients with a post-traumatic compression fracture in the junctional region are at great risk of conservative treatment failure. These patients should be well-informed about the possible complications and poor results of conservative treatment, and surgical treatment should be considered in selective cases with the informed consent of the patients.
authors.affiliation: Department of Orthopaedic and Traumatology, Ankara Numune Training and Research Hospital, 06100 Altindag, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Cankaya
authors.affiliation: Department of Orthopaedic and Traumatology, Ankara Numune Training and Research Hospital, 06100 Altindag, Ankara, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Yilmaz
authors.affiliation: Department of Orthopaedic and Traumatology, Ankara Numune Training and Research Hospital, 06100 Altindag, Ankara, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Deveci
authors.affiliation: Department of Orthopaedic and Traumatology, Ankara Numune Training and Research Hospital, 06100 Altindag, Ankara, Turkey.
authors.forename: Abdurrahim
authors.initials: A
authors.lastname: Dundar
authors.affiliation: Department of Orthopaedic and Traumatology, Ankara Numune Training and Research Hospital, 06100 Altindag, Ankara, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Yoldas
authors.affiliation: Department of Orthopaedic and Traumatology, Aksaray State Hospital, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Toprak
authors.affiliation: Department of Orthopaedic and Traumatology, Ankara Numune Training and Research Hospital, 06100 Altindag, Ankara, Turkey.
authors.forename: Yalcın
authors.initials: Y
authors.lastname: Tabak
keywords: Brace; Conservative treatment; Elderly; Stable thoracolumbar fracture; TLICS