Comparison of operative and nonoperative treatment for thoracolumbar burst fractures in patients without neurological deficit: a systematic review

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Object

Despite extensive published research on thoracolumbar burst fractures, controversy still surrounds which is the most appropriate treatment. The objective of this study was to evaluate the scientific literature on operative and nonoperative treatment of patients with thoracolumbar burst fractures and no neurological deficit.

Methods

In their search of the literature, the authors identified all possible relevant studies concerning thoracolumbar burst fracture without neurological deficit. Two independent observers performed study selection, methodological quality assessment, and data extraction in a blinded and objective manner for all papers identified during the search. In a synthesis of the literature, the authors obtained evidence for both operative and nonoperative treatments.

Conclusions

There is a lack of evidence demonstrating the superiority of one approach over the other as measured using generic and disease-specific health-related quality of life scales. There is no scientific evidence linking posttraumatic kyphosis to clinical outcomes. The authors found that there is a strong need for improved clinical research methodology to be applied to this patient population.

Abbreviations used in this paper: HRQOL = health-related quality of life; ODI = Oswestry Disability Index; PS = pedicle screw; RCT = randomized controlled trial; RMDS = Roland–Morris Disability Scale; SF-36 = 36-Item Short Form Health Survey; TLSO = thoracolumbosacral orthosis; VAS = visual analog scale; VB = vertebral body.

Article Information

Address reprint requests to: Charles Fisher, M.D., D6 Heather Pavilion, 2733 Heather Street, Vancouver General Hospital, Vancouver, British Columbia, V5Z 3J5, Canada. email: cfisher@vanhosp.bc.ca.

© AANS, except where prohibited by US copyright law.

Headings

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