Seminars in Spine Surgery
Volume 22, Issue 1 , Pages 38-43 , March 2010

Operative versus Nonoperative Treatment of Thoracolumbar Burst Fractures

  • Adam L. Shimer, MD

      Affiliations

    • Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA
    • Corresponding Author InformationAddress reprint requests to Adam L. Shimer, MD, Department of Orthopaedic Surgery, University of Virginia Medical Center, Charlottesville, VA
  • ,
  • Brian W. Su, MD

      Affiliations

    • Mt Tam Spine Center, Larkspur, CA

References 

  1. Jones RW. Manipulative reduction of crush fractures of the spine. Br Med J. 1931;1:300–302
  2. Holdsworth FW. Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg Am. 1970;52:1534–1551
  3. Holdsworth FW. Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg Br. 1963;45:6–20
  4. Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine. 1983;8:817–831
  5. Ferguson RL, Allen BL. A mechanistic classification of thoracolumbar spine fractures. Clin Orthop Relat Res. 1984;189:77–88
  6. Magerl F, Aebi M, Gertzbein SD, et al. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J. 1994;3:184–201
  7. White AA, Panjabi M. Clinical biomechanics of the spine. Philadelphia, PA: Lippincott; 1978;
  8. James KS, Wenger KH, Schlegel JD, et al. Biomechanical evaluation of the stability of thoracolumbar burst fractures. Spine. 1994;19:1731–1740
  9. Vaccaro AR, Baron EM, Sanfilippo J, et al. Reliability of a novel classification system for thoracolumbar injuries: the thoracolumbar injury severity score. Spine. 2006;31:S62–S69discussion S104
  10. Vaccaro AR, Zeiller SC, Hulbert RJ, et al. The thoracolumbar injury severity score: a proposed treatment algorithm. J Spinal Disord Tech. 2005;18:209–215
  11. Spinal Orthotics. eMedicine. 2008;http://emedicine.medscape.com/article/314921-overview
  12. Axelsson P, Johnsson R, Stromqvist B. Effect of lumbar orthosis on intervertebral mobility (A roentgen stereophotogrammetric analysis). Spine. 1992;17:678–681
  13. Giele BM, Wiertsema SH, Beelen A, et al. No evidence for the effectiveness of bracing in patients with thoracolumbar fractures. Acta Orthop. 2009;80:226–232
  14. Wood KB, Bohn D, Mehbod A. Anterior versus posterior treatment of stable thoracolumbar burst fractures without neurologic deficit: a prospective, randomized study. J Spinal Disord Tech. 2005;18(suppl):S15–S23
  15. Ghanayem AJ, Zdeblick TA. Anterior instrumentation in the management of thoracolumbar burst fractures. Clin Orthop Relat Res. 1997;335:89–100
  16. Marco RA, Kushwaha VP. Thoracolumbar burst fractures treated with posterior decompression and pedicle screw instrumentation supplemented with balloon-assisted vertebroplasty and calcium phosphate reconstruction. J Bone Joint Surg Am. 2009;91:20–28
  17. Dai LY, Jiang LS, Jiang SD. Posterior short-segment fixation with or without fusion for thoracolumbar burst fractures (A five to seven-year prospective randomized study). J Bone Joint Surg Am. 2009;91:1033–1041
  18. Willen J, Anderson J, Toomoka K, et al. The natural history of burst fractures at the thoracolumbar junction. J Spinal Disord. 1990;3:39–46
  19. Mumford J, Weinstein JN, Spratt KF, et al. Thoracolumbar burst fractures (The clinical efficacy and outcome of nonoperative management). Spine. 1993;18:955–970
  20. Vaccaro AR, Nachwalter RS, Klein GR, et al. The significance of thoracolumbar spinal canal size in spinal cord injury patients. Spine. 2001;26:371–376
  21. Wilcox RK, Boerger TO, Hall RM, et al. Measurement of canal occlusion during the thoracolumbar burst fracture process. J Biomech. 2002;35:381–384
  22. Limb D, Shaw DL, Dickson RA. Neurological injury in thoracolumbar burst fractures. J Bone Joint Surg Br. 1995;77:774–777
  23. Dall BE, Stauffer ES. Neurologic injury and recovery patterns in burst fractures at the T12 or L1 motion segment. Clin Orthop Relat Res. 1988;233:171–176
  24. Kang JD, Figgie MP, Bohlman HH. Sagittal measurements of the cervical spine in subaxial fractures and dislocations (An analysis of two hundred and eighty-eight patients with and without neurological deficits). J Bone Joint Surg Am. 1994;76:1617–1628
  25. Matsuura P, Waters RL, Adkins RH, et al. Comparison of computerized tomography parameters of the cervical spine in normal control subjects and spinal cord-injured patients. J Bone Joint Surg Am. 1989;71:183–188
  26. Meves R, Avanzi O. Correlation among canal compromise, neurologic deficit, and injury severity in thoracolumbar burst fractures. Spine. 2006;31:2137–2141
  27. Hashimoto T, Kaneda K, Abumi K. Relationship between traumatic spinal canal stenosis and neurologic deficits in thoracolumbar burst fractures. Spine. 1988;13:1268–1272
  28. Cantor JB, Lebwohl NH, Garvey T, et al. Nonoperative management of stable thoracolumbar burst fractures with early ambulation and bracing. Spine. 1993;18:971–976
  29. Kim NH, Lee HM, Chun IM. Neurologic injury and recovery in patients with burst fracture of the thoracolumbar spine. Spine. 1999;24:290–293discussion 294
  30. Weinstein JN, Collalto P, Lehmann TR. Thoracolumbar “burst” fractures treated conservatively: a long-term follow-up. Spine. 1988;13:33–38
  31. Delamarter RB, Sherman J, Carr JB. Pathophysiology of spinal cord injury (Recovery after immediate and delayed decompression). J Bone Joint Surg Am. 1995;77:1042–1049
  32. Gertzbein SD Scoliosis Research Society. Multicenter spine fracture study. Spine. 1992;17:528–540
  33. Hartman MB, Chrin AM, Rechtine GR. Non-operative treatment of thoracolumbar fractures. Paraplegia. 1995;33:73–76
  34. Kostuik JP, Harrington I, Alexander D, et al. Cauda equina syndrome and lumbar disc herniation. J Bone Joint Surg Am. 1986;68:386–391
  35. Gaines RW, Humphreys WG. A plea for judgment in management of thoracolumbar fractures and fracture-dislocations (A reassessment of surgical indications). Clin Orthop Relat Res. 1984;189:36–42
  36. Thomas KC, Bailey CS, Dvorak MF, et al. Comparison of operative and nonoperative treatment for thoracolumbar burst fractures in patients without neurological deficit: a systematic review. J Neurosurg Spine. 2006;4:351–358
  37. Yi L, Jingping B, Gele J, et al. Operative versus non-operative treatment for thoracolumbar burst fractures without neurological deficit. Cochrane Database Syst Rev. 2006;4:CD005079
  38. Shen WJ, Liu TJ, Shen YS. Nonoperative treatment versus posterior fixation for thoracolumbar junction burst fractures without neurologic deficit. Spine. 2001;26:1038–1045
  39. Wood K, Buttermann G, Mehbod A, et al. Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit (A prospective, randomized study). J Bone Joint Surg Am. 2003;85:773–781
  40. Siebenga J, Leferink VJ, Segers MJ, et al. Treatment of traumatic thoracolumbar spine fractures: a multicenter prospective randomized study of operative versus nonsurgical treatment. Spine. 2006;31:2881–2890
  41. Domenicucci M, Preite R, Ramieri A, et al. Thoracolumbar fractures without neurosurgical involvement: surgical or conservative treatment?. J Neurosurg Sci. 1996;40:1–10
  42. Hazel WA, Jones RA, Morrey BF, et al. Vertebral fractures without neurological deficit (A long-term follow-up study). J Bone Joint Surg Am. 1988;70:1319–1321
  43. Kraemer WJ, Schemitsch EH, Lever J, et al. Functional outcome of thoracolumbar burst fractures without neurological deficit. J Orthop Trauma. 1996;10:541–544

PII: S1040-7383(09)00082-3

doi: 10.1053/j.semss.2009.10.005

Seminars in Spine Surgery
Volume 22, Issue 1 , Pages 38-43 , March 2010