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Review Question - QID 3135

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QID 3135 (Type "3135" in App Search)
In patients with a stable thoracolumbar burst fracture and no neurologic deficits, operative treatment has what long term outcome when compared to nonoperative management.

Improved sagittal balance

13%

645/4855

Decreased pain scores

5%

235/4855

Improved return to work status

6%

298/4855

Improved function

2%

85/4855

Increased disability and complications

74%

3571/4855

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Although a very controversial topic, evidence supports in patients with stable thoracolumbar burst fracture without neurologic deficits, there is no advantages to surgical treatment.

Wood et al performed the first radomized control trial comparing operative versus nonoperative treatment of thoracolumbar burst fractures in patients with no neurological deficits. They found no major long-term advantages with operative treatment, and increased disability and complications with operative treatment.

Gnanenthiran et al performed a meta-analysis to look at nonoperative versus operative treatment for thoracolumbar burst fractures without neurologic deficit. At final follow up they found no between-group differences in pain, Roland Morris Disability Questionnaire scores, and return to work rates.

Agus et al found that regardless of the number of columns involved, nonoperative treatment led to satisfactory results with no neurologic deterioration in their cohort of 29 patients. They conclude that nonoperative treatment is a viable option in patients with intact two- and three-column-injured Denis-types A, B and C thoracolumbar burst fractures.

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