STUDY DESIGN: 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. SUMMARY OF BACKGROUND DATA: 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.
RCT Entities:
STUDY DESIGN: 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. SUMMARY OF BACKGROUND DATA: 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.
Authors: Said Sadiqi; A Mechteld Lehr; Marcel W Post; Marcel F Dvorak; Frank Kandziora; S Rajasekaran; Klaus J Schnake; Alexander R Vaccaro; F Cumhur Oner Journal: Eur Spine J Date: 2017-03-17 Impact factor: 3.134
Authors: Andrei F Joaquim; Brandon Lawrence; Michael Daubs; Darrel Brodke; Helder Tedeschi; Alexander R Vaccaro; Alpesh A Patel Journal: J Spinal Cord Med Date: 2013-11-26 Impact factor: 1.985
Authors: Boukje M Giele; Suzanne H Wiertsema; Anita Beelen; Marike van der Schaaf; Cees Lucas; Henk D Been; Jos A M Bramer Journal: Acta Orthop Date: 2009-04 Impact factor: 3.717